[1]王经伟 甄东 邱冰**.不同切口长度及缝合方式的跟腱手术切口愈合情况的比较[J].中国微创外科杂志,2021,01(5):415-419.
 Wang Jingwei,Zhen Dong,Qiu Bing..Comparisons of the Wound Healing Following the Open Operation of Achilles Tendon Rupture with Different Incision Sizes and Closing Sutures[J].Chinese Journal of Minimally Invasive Surgery,2021,01(5):415-419.
点击复制

不同切口长度及缝合方式的跟腱手术切口愈合情况的比较()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年5期
页码:
415-419
栏目:
临床研究
出版日期:
2021-05-25

文章信息/Info

Title:
Comparisons of the Wound Healing Following the Open Operation of Achilles Tendon Rupture with Different Incision Sizes and Closing Sutures
作者:
王经伟 甄东 邱冰**
(贵州省骨科医院运动医学科,贵阳550002)
Author(s):
Wang Jingwei Zhen Dong Qiu Bing.
Department of Orthopedics Surgery, Guizhou Orthopedics Hospital, Guiyang 550002, China
关键词:
跟腱撕裂有限切开切口并发症皮下缝合
Keywords:
Achilles tendon ruptureMinimally invasive incisionIncision complicationSubcutaneous suture
文献标志码:
A
摘要:
目的比较传统切口(14 cm)皮下缝合、有限切开(5~8 cm)间断褥式缝合和有限切开皮下缝合后跟腱手术切口的愈合情况。方法本研究为前瞻性同期平行对照临床研究。选择2016年8月~2019年12月MRI诊断的急性跟腱断裂67例,按照入院时间顺序依次纳入传统切口皮下缝合组(n=22)、有限切开间断褥式缝合组(n=22)、有限切开皮下缝合组(n=23)。随访至术后2个月,比较围手术指标和切口愈合情况。结果有限切开间断褥式缝合组、有限切开皮下缝合组的切口感染(1/22、0/23),延迟愈合(2/22、2/23)以及总并发症发生率(2/22、2/23)均低于传统切口组(5/22,P=0.019;8/22,P=0023;8/22,P=0.023)。2个有限切开组之间的差异均无统计学意义(P>0.05)。结论与传统切口皮下缝合相比,有限切开皮下缝合或间断褥式缝合的切口并发症发生率更低。
Abstract:
ObjectiveTo compare the wound healing of the Achilles tendon incision with the traditional incision (14 cm) and subcutaneous suture, the minimally invasive incision (5-8 cm) and interrupted mattress suture, and the minimally invasive incision and subcutaneous suture.MethodsThis study was a prospective parallelcontrolled clinical study. A total of 67 patients diagnosed as acute Achilles tendon rupture by MRI from August 2016 to December 2019 were included. The patients were divided into three groups orderly according to time sequence: traditional incision+subcutaneous suture group (n=22), minimally invasive incision+intermittent mattress suture (n=22), and minimally invasive incision+subcutaneous suture group (n=23). All the patients were followed up for 2 months. The perioperative measures and wound healing were observed and analyzed.ResultsThe rates of wound infection (1/22, 0/23), delayed healing (2/22, 2/23), as well as the total complication rate (2/22, 2/23) of the minimally invasive incision+ interrupted mattress suture group and minimally invasive incision+ subcutaneous suture group were significantly lower than the traditional incision group (5/22, P=0.019; 8/22, P=0.023; 8/22, P=0.023). However, there was no difference between the two minimally invasive groups (P>0.05).ConclusionComparing to the traditional incision with subcutaneous suture, the minimally invasive incision with subcutaneous/intermittent mattress suture has lower rate of complications.

参考文献/References:

[1]马利杰,姚双权,吴昊天,等.经皮复位固定技术治疗严重塌陷型跟骨关节内骨折的近期疗效分析.中国微创外科杂志,2019,19(9):817-820.
[2]Holm C,Kjaer M,Eliasson P.Achilles tendon rupturetreatment and complications:a systematic review.Scand J Med Sci Sports,2015,25(1):e1-10.
[3]Molloy A,Wood EV.Complications of the treatment of Achilles tendon ruptures.Foot Ankle Clin,2009,14(4):745-759.
[4]Saxena A,Maffulli N,Nguyen A,et al.Wound complications from surgeries pertaining to the Achilles tendon:an analysis of 219 surgeries.J Am Podiatr Med Assoc,2008,98(2):95-101.
[5]Bruggeman NB,Turner NS,Dahm DL,et al.Wound complications after open Achilles tendon repair: an analysis of risk factors.Clin Orthop Relat Res,2004,(427):63-66.
[6]Willits K,Amendola A,Bryant D,et al.Operative versus nonoperative treatment of acute Achilles tendon ruptures:a multicenter randomized trial using accelerated functional rehabilitation.J Bone Joint Surg Am,2010,92(17):2767-2775.
[7]Knobe M,Gradl G,Klos K,et al.Is percutaneous suturing superior to open fibrin gluing in acute Achilles tendon rupture?Int Orthop,2015,39(3):535-542.
[8]Aktas S,Kocaoglu B.Open versus minimal invasive repair with Achillon device.Foot Ankle Int,2009,30(5):391-397.
[9]Park YH,Chang AS,Choi GW,et al.A comparison of three methods of skin closure following repair of Achilles tendon rupture.Injury,2018,49(10):1942-1946.
[10]Liang X,HanXin Z,ChangE J,et al.Subcutaneous suture can accelerate wound healing of lower midline incision:a randomized controlled trial.Am Surg,2015,81(1):23-30.
[11]焦晨,郭秦炜,陶昊,等.跟腱Haglund病的手术治疗.中国运动医学杂志,2013,32(1):5-9.
[12]陆生林,白宇,庄小强.小切口皮下缝合修复新鲜跟腱断裂.中国修复重建外科杂志,2009,23(8):1022-1023.
[13]Kitaoka HB,Alexander IJ,Adelaar RS,et al.Clinical rating systems for the anklehindfoot,midfoot,hallux,and lesser toes.Foot Ankle Int,1994,15(7):349-353.
[14]江东,胡跃林,焦晨,等.改良辅助入路全关节镜下修复踝关节外侧副韧带.中国微创外科杂志,2019,19(1):11-14.
[15]He ZY,Chai MX,Liu YJ,et al.Percutaneous repair technique for acute Achilles tendon rupture with assistance of kirschner wire.Orthop Surg,2015,7(4):359-363.
[16]Yang B,Liu Y,Kan S,et al.Outcomes and complications of percutaneous versus open repair of acute Achilles tendon rupture:a metaanalysis.Int J Surg,2017,40:178-186.
[17]Henríquez H,Muoz R,Carcuro G,et al.Is percutaneous repair better than open repair in acute Achilles tendon rupture?Clin Orthop Relat Res,2012,470(4):998-1003.
[18]姜健,孙强,苏云,等.改良跟腱内侧弧形切口联合改良垂直间断褥式缝合法治疗新鲜跟腱断裂.实用骨科杂志,2019,25(1):84-86.
[19]董新利,苏云,孙强,等.改良间断垂直褥式缝合方法在关闭跟骨骨折切口中的应用.实用骨科杂志,2017,23(2):185-187.
[20]陈涛,余润泽.缝合器与缝线在跟骨骨折患者皮肤缝合中应用效果比较.安徽医学,2017,38(8):1028-1030.
[21]余江,胡兆洋,李光胜,等.不同缝合方法预防或减少跟骨骨折切口并发症的对比研究.实用医学杂志,2018,34(1):93-95,99.

备注/Memo

备注/Memo:
基金项目:贵阳市科技计划([2018]1-69)**通讯作者,Email:yz8088gk@163.com
更新日期/Last Update: 2021-08-06