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跟骨外侧延长L形切口并发症的危险因素分析
Hits: 2513   Download times: 1081   Received:August 02, 2016    
作者Author单位UnitE-Mail
范新星 FAN Xin-xing 湖州市中心医院骨科, 浙江 湖州 313000 Department of Orthopaedics, the Central Hospital of Huzhou, Huzhou 313000, Zhejiang, China  
沈彦 SHEN Yang 中国人民解放军第九八医院骨科, 浙江 湖州 313000 louissy@aliyun.com 
谢文龙 XIE Wen-long 湖州市中心医院骨科, 浙江 湖州 313000 Department of Orthopaedics, the Central Hospital of Huzhou, Huzhou 313000, Zhejiang, China  
期刊信息:《中国骨伤》2017年30卷,第4期,第339-344页
DOI:10.3969/j.issn.1003-0034.2017.04.011


目的:探讨跟骨外侧延长“L”形切口治疗闭合性跟骨骨折术后发生切口并发症的相关危险因素,明确降低切口并发症的有效干预手段。

方法:回顾性分析2011年1月至2015年1月收治的285例(315足)行跟骨外侧延长“L”形切口治疗闭合性跟骨骨折患者的临床资料,对可能影响术后切口并发症的18个临床相关危险因素进行单因素分析,对存在统计差异的变量再给予多因素Logistic回归分析。

结果:285例(315足)共有29例(30足)出现切口并发症,其中切口皮缘红肿渗出、不愈合9足,皮缘发黑坏死或者切口裂开16足,皮肤软组织浅层感染3足,骨髓炎2足。单因素分析结果显示:坠落高度(P=0.017)、糖尿病病史(P=0.026)、吸烟史(P=0.001)、手术时间(P=0.003)4个因素差异有统计学意义,将这些因素再进行多因素Logistic回归分析,发现糖尿病(P=0.029)、吸烟史(P<0.001)、手术时间(P=0.018)是跟骨外侧延长“L”形切口术后并发症的危险因素。

结论:术前戒烟、积极控制血糖以及熟悉手术操作,有效减短手术时间可以减少跟骨外侧延长“L”形切口并发症的发生率。
[关键词]:跟骨  骨折  手术后并发症  危险因素
 
Risk factors analysis on wound complications after closed calcaneal frature operation using lateral extensive L-shaped incision
Abstract:

Objective: To investigate the risk factors of wound complications after closed calcaneal fracture operation using a lateral extensive L-shaped incision and to explore the effective interventions to reduce the complications after incision.

Methods: Retrospective analysis of clinical data of 285 patients(315 calcaneal fractures) who underwent open reduction and internal fixation by using the lateral extensive L-shaped incision from January 2011 to January 2015. Eighteen factors which might cause the complications of calcaneal incision were compared by univariate analysis,and multiple Logistic regression analysis was performed for factors with statistically significances.

Results: Twenty-nine patients(30 calcaneus) had wound complications among all the 285 patients(315 calcaneus) after surgery,including 9 patients with incision redness,swelling,oozing or nonunion;16 patients with skin necrosis or incision rupture,3 patients with soft tissue superficial infection,and 2 patients with osteomyelitis. Univariate analysis showed that fall height(P=0.017),diabetes (P=0.026),smoking(P=0.001),and operative time(P=0.003) were correlated with incision complications after surgery. Multivariate analysis showed that diabetes(P=0.029),smoking(P<0.001),and operative time(P=0.018) were risk factors for incision complications after operation.

Conclusion: Preoperative smoking cessation,actively control of blood glucose and shortening the operation time by practicing can effectively reduce the incision complication after fracture surgery with the lateral extensive L-shaped incision.
KEYWORDS:Calcaneus  Fractures  Postoperative complications  Risk factors
 
引用本文,请按以下格式著录参考文献:
中文格式:范新星,沈彦,谢文龙.跟骨外侧延长L形切口并发症的危险因素分析[J].中国骨伤,2017,30(4):339~344
英文格式:FAN Xin-xing,SHEN Yang,XIE Wen-long.Risk factors analysis on wound complications after closed calcaneal frature operation using lateral extensive L-shaped incision[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(4):339~344
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