Allgower-Donati缝合法在踝部骨折手术切口缝合中的应用效果  

Application effect of Allgower-Donati technique in suture of ankle fracture surgical incision

作　　者：李军[1] 余浩 谢佳 王方圆 吴慧雯 姚运峰[1] 詹俊锋[1] 张积森[1] 许新忠[1] 荆珏华[1] 梁帅 LI Jun;YU Hao;XIE Jia;WANG Fang-yuan;WU Hui-wen;YAO Yun-feng;ZHAN Jun-feng;ZHANG Ji-sen;XU Xin-zhong;JING Jue-hua;LIANG Shuai(Department of Orthopaedics,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院骨科,安徽合肥230601

出　　处：《中国临床研究》2022年第4期493-497,共5页Chinese Journal of Clinical Research

基　　金：安徽省重点研究与开发计划项目(201904b11020032);安徽医科大学基础与临床合作研究促进项目(2020xkjT040);安徽医科大学第二附属医院临床研究培育计划项目(2020LCZD20)。

摘　　要：目的比较Allgower-Donati缝合法与间断垂直褥式缝合法对踝部骨折术后切口愈合的影响。方法选取2018年1月至2019年10月在安徽医科大学第二附属医院行手术治疗的101例踝部骨折患者的临床资料进行回顾性分析,依据关闭切口的缝合方式不同分为试验组(51例)和对照组(50例),试验组使用Allgower-Donati缝合法关闭切口,对照组使用间断垂直褥式缝合法关闭切口。记录并随访两组的缝合时间、手术时间、切口皮肤温度差值、切口周围皮肤炎性反应面积和切口愈合等情况。结果术后两组患者均获得至少6个月随访,试验组切口缝合时间短于对照组(P<0.05);切口周围皮肤炎性反应面积小于对照组(P<0.05);术后第2、3天切口皮肤温度差值小于对照组(P<0.05)。试验组甲级愈合率96.08%,皮肤切口并发症发生率3.92%,2例切口愈合欠佳,稍有渗液;对照组甲级愈合率92.00%,皮肤切口并发症发生率8.00%,4例术后发生切口并发症的患者中,3例切口愈合欠佳,皮肤发黑,有淡黄色渗液,1例钢板外露。结论在缝合踝部骨折的切口时,与传统的间断垂直褥式缝合法相比,使用Allgower-Donati缝合法的缝合时间更短,切口周围皮肤炎性反应面积更小,恢复情况更好。Objective To compare the effects of Allgower-Donati suture and interrupted vertical mattress suture on incision healing after ankle fracture surgery.Methods A retrospectively analysis was conducted on the data of 101 patients with ankle fracture undergoing open reduction and internal fixation in the Second Affiliated Hospital of Anhui Medical University from January 2018 to October 2019.According to the different incision suture methods,the patients were divided into experimental group(with Allgower-Donati suture,n=51)and control group(with interrupted vertical mattress suture,n=50).The suture time,operation time,incision skin temperature difference,skin inflammatory reaction area around the incision and incision healing were recorded and followed up in two groups.Results During the follow-up of at least 6 months after operation,the incision suture time in experimental group was shorter than that in control group(P<0.05),the skin inflammatory reaction area around the incision was significantly less than that in control group(P<0.05),and the difference of skin temperature was lower than that in control group on the 2nd and 3rd day after operation(P<0.05).In experimental group,the healing rate of grade A was 96.08%,the incidence of incisional complications was 3.92%,and the incision healed poorly with slight exudate in 2 cases.In control group,the healing rate of grade A was 92.00%,the incidence of incisional complications was 8.00%,the incision healed poorly with dark skin and yellowish exudate occurred in 3 cases,and the exposed steel-plate was found in 1 case.Conclusion In surgical incision suture of patients with ankle fracture,compared with the traditional interrupted vertical mattress suture,Allgower-Donati suture has shorter suture time,smaller inflammatory reaction surrounding the incision and better recovery.

关 键 词：踝部骨折 切口缝合技术 Allgower-Donati缝合法 间断垂直褥式缝合法 切口愈合 

分 类 号：R683.42[医药卫生—骨科学]