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跟骨骨折切开复位内固定术后切口并发症分析 被引量:18

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摘要 目的总结预防跟骨骨折切开复位内固定术后切口并发症的方法。方法回顾分析2004年8月-2008年4月收治的56例64侧跟骨关节内骨折患者临床资料。其中男41例,女15例;年龄21~62岁,平均36岁。单侧48例,双侧8例。按Sanders分型:Ⅱ型18侧,Ⅲ型43侧,Ⅳ型3侧。受伤至手术时间3h~14d,平均7.5d。行跟骨骨折切开复位钢板内固定术,观察术后切口并发症发生情况。结果术后8例11侧发生局部切口并发症,发生率为17.2%,其中伤口乙级愈合9侧,丙级愈合2侧。11侧中切口裂开6侧,局部皮肤坏死3侧,发生感染2侧。分析原因发现4侧为未待水肿明显消退即进行手术;3侧为手术时间>2h;2侧为医生对手术入路解剖不完全熟悉、术中对皮瓣保护意识不强所致;2侧原因不明,可能与术后过早拔除引流有关。余53侧切口均甲级愈合。结论骨折后待皮肤皱褶征阳性再行手术、缩短手术时间及止血带使用时间、熟悉手术入路的解剖特点、熟练掌握全层切开皮肤和"不接触"皮肤保护技术、锐性分离皮瓣方法及术后恰当处理是预防切口并发症的有效途径。
机构地区 解放军第
出处 《中国修复重建外科杂志》 CAS CSCD 北大核心 2009年第11期1407-1408,共2页 Chinese Journal of Reparative and Reconstructive Surgery
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参考文献8

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