皮内缝合联合皮肤黏合剂关闭切口对全膝关节置换术患者预后的影响  

Effect of Intradermal Suture Combined with Skin Adhesive Closing Incision on Prognosis of Patients Undergoing Total Knee Arthroplasty

作　　者：陈静[1] 单燕 陈敏[1] CHEN Jing;SHAN Yan;CHEN Min(Department of Orthopedics,No.904 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Wuxi 214041,Jiangsu,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科二区,江苏无锡214041

出　　处：《中国美容医学》2021年第12期17-21,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究皮内缝合联合皮肤黏合剂关闭切口对全膝关节置换术(Total knee arthroplasty,TKA)患者切口愈合、瘢痕情况及膝关节活动度的影响。方法:选取笔者医院2017年5月-2019年6月行TKA患者114例(126膝),按照随机数字表法分为观察组与对照组。采取皮内缝合联合皮肤黏合剂关闭切口的57例(64膝)作为观察组,采取传统缝合关闭切口的57例(62膝)作为对照组。比较两组切口缝合时间、换药次数、住院时间、术后切口疼痛(Visual analogue scale,VAS)评分、Hollander切口愈合(Hollander wound evaluating score,HWES)评分、患者瘢痕自我评分(Patient scar assessment score,PSAS)、观测者瘢痕评价评分(Observer scar assessment score,OSAS)、手术前后膝关节活动度,并统计两组切口并发症及患者切口美观满意度情况。结果:观察组换药次数、住院时间短于对照组,术后3d、5d、7d、出院时切口VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组术后1周、2周、6周、12周、24周HWES评分高于对照组,PSAS、OSAS评分低于对照组,差异有统计学意义(P<0.05)。两组术后12周、24周膝关节伸直度、屈曲度、屈曲弧度较术前显著改善(P<0.05),但组间比较差异无统计学意义(P>0.05)。观察组切口并发症发生率低于对照组,患者对切口美观满意度高于对照组,差异有统计学意义(P<0.05)。结论:皮内缝合联合皮肤黏合剂关闭切口可缩短TKA患者住院时间,减少换药次数,减轻术后疼痛,促进切口愈合、膝关节功能恢复,改善切口瘢痕情况,患者对切口美观满意度高。Objective To explore the effect of intradermal suture combined with skin adhesive to close the incision on incision healing,scarring and knee joint range of motion in patients undergoing total knee arthroplasty(TKA).Methods A total of 114 patients(126 knees)underwent TKA in our hospital from May 2017 to June 2019 were selected and divided into the observation group and the control group according to the random number table method.Fifty-seven cases(64 knees)with intradermal suture combined with skin adhesive to close the incision were used as the observation group,and 57 cases(62 knees)with traditional suture to close the incision were used as the control group.The incision suture time,the number of dressing changes,the length of hospital stay,the postoperative incision pain(VAS)score,and the Hollander wound evaluating score(HWES),patient scar assessment score(PSAS),observer scar assessment score(OSAS),and range of motion of the knee joint before and after the operation were compared between the two groups,and the incision complications and the patient's satisfaction with the incision aesthetics were statistically compared of the two groups.Results The dressing change times and hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).The VAS score of the incision in the observation group was lower than those of the control group at 3,5,and 7 days after operation and at discharge(P<0.05).The HWES score of the observation group was higher than that of the control group at 1,2,6,12 and 24 weeks after operation,and the PSAS and OSAS scores were lower than those of the control group(P<0.05).The knee extension,fl exion and fl exion radian of the two groups were significantly improved at 12 and 24 weeks after operation(P<0.05).But there was no significant difference between the two groups(P>0.05).The incidence of incision complications in the observation group was lower than that in the control group(P<0.05).The patients'satisfaction with i

关 键 词：全膝关节置换术 皮内缝合 皮肤黏合剂 切口愈合 瘢痕 膝关节活动度 

分 类 号：R622[医药卫生—整形外科]