[1]刘志久,袁光辉.间断横褥式缝合对预防跟骨骨折术后切口并发症的作用[J].中医正骨,2012,24(10):26-28.
　LIU Zhi-jiu*,YUAN Guang-hui..The preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(10):26-28.
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间断横褥式缝合对预防跟骨骨折术后切口并发症的作用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期数:
2012年10期
页码:
26-28
栏目:
临床研究
出版日期:
2012-10-20

文章信息/Info

Title:
The preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures
作者:
刘志久; 袁光辉
河南省开封市中医院,河南 开封 475001
Author(s):
LIU Zhi-jiu*; YUAN Guang-hui.
*Traditional Chinese Medical Hospital of Kaifeng City,Kaifeng 475001,Henan,China
关键词:
跟骨 骨折固定术; 内 手术后并发症 缝合技术
Keywords:
Calcaneus;  Fracture fixation; internal;  Postoperative complications;  Suture techniques
摘要:
目的:探讨间断横褥式缝合对预防跟骨骨折术后切口并发症的作用。方法:回顾性分析外侧入路切开复位钢板内固定治疗跟骨骨折患者的病例资料。纳入研究的患者共92例107足,男86例,女6例。年龄17～66岁,中位数37.5岁。受伤至手术时间7～12 d,中位数9.5 d。其中采用间断横褥式缝合者55例63足(Ⅰ组),采用分层缝合者37例44足(Ⅱ组)。分别统计2组患者术后切口及周围张力性水疱、切口皮缘坏死、缝线切割皮缘、钢板外露等切口并发症的发生情况。结果:Ⅰ组术后3足出现切口部位张力性水疱,1足发生切口部位皮缘坏死,换药后痊愈; Ⅱ组术后4足出现皮缘坏死,经换药后痊愈; 3足同时发生张力性水疱、切口皮缘坏死及缝线切割皮缘,经换药后痊愈; 2足出现张力性水疱,经换药后痊愈; 1足出现钢板外露,经皮瓣转移后痊愈。2组患者张力性水疱、缝线切割皮缘及钢板外露发生率比较,差异无统计学意义(χ2=0.817,P=0.366; P=0.067; P=0.411); Ⅱ组切口皮缘坏死及切口并发症总体发生率高于Ⅰ组(χ2=5.751,P=0.017; χ2=6.111,P=0.013)。结论:间断横褥式缝合可以降低跟骨骨折术后切口并发症的发生率,值得推广应用。
Abstract:
To explore the preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures.Methods:The medical records of patients with calcaneus fractures treated by open reduction and plate internal fixation through the lateral approach were analyzed retrospectively.Ninety-two patients(107 feet)were included into the study,male 86 cases,while female 6 cases; ranging in age from 17 to 66 years with a median of 37.5 years; ranging from 7 to 12 days with a median of 9.5 days in time intervals from injury to surgery.Sixty-three feet of 55 patients(groupⅠ)were administrated with discontinuous transverse mattress suture,while 44 feet of 37 patients(groupⅡ)were administrated with layered suture.Such incision complications as tension blister around the incision,skin necrosis at the incision margin,cutting incision skin by sutures,plate exposure were recorded respectively.Results:After the operation,four feet with tension blister around the incision and one foot with skin necrosis at the incision margin were found in groupⅠ,which were all healed after dressing change.For the patients in groupⅡ,four feet with skin necrosis at the incision margin,three feet with simultaneous signss of tension blister,skin necrosis at the incision margin and cutting incision skin by sutures and two feet with tension blister were found and were healed after dressing change,and one case with plate exposure was found and healed after flap transplantation.There were no statistical difference in incidence rate of tension blister,cutting incision skin by sutures and plate exposure between the two groups(χ2=0.817,P=0.366; P=0.067; P=0.411); while the incidence rate of skin necrosis at the incision margin and the overall incision complications of groupⅡwas higher than that of groupⅠ(χ2=5.751,P=0.017; χ2=6.111,P=0.013).Conclusion:The incidence rate of postoperative incision complications of calcaneus fractures can be reduced by discontinuous transverse mattress suture,and it is worthy of popularizing in clinic.

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更新日期/Last Update: 2012-10-20