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  

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 Wang Jingwei;Zhen Dong;Qiu Bing(Department of Orthopedics Surgery, Guizhou Orthopedics Hospital, Guiyang 550002, China)

机构地区：[1]贵州省骨科医院运动医学科,贵阳550002

出　　处：《中国微创外科杂志》2021年第5期415-419,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：贵阳市科技计划([2018]1-69)。

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。Objective To 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.Methods This 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.Results The 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).Conclusion Comparing to the traditional incision with subcutaneous suture,the minimally invasive incision with subcutaneous/intermittent mattress suture has lower rate of complications.

关 键 词：跟腱撕裂 有限切开 切口并发症 皮下缝合 

分 类 号：R687.2[医药卫生—骨科学]