闭合性跟骨骨折术后发生切口并发症的相关因素及预防策略
Related Factors and Prevention Strategies of Incision Complications after Closed Calcaneal Fracture Surgery
摘要: 随着医疗水平的不断提高,闭合性跟骨骨折的治疗手段也越来越丰富,但术后切口并发症的发生率却一直居高不下,对患者造成了极大的困扰。闭合性跟骨骨折术后切口并发症的发生因素及预防策略在临床上一直存在着争议,经验不丰富的医生也存在着许多关于其切口并发症的发生及防止上的盲点。本文从闭合性跟骨骨折术后发生切口并发症的相关因素及预防策略进行综述。
Abstract: With the continuous improvement of medical level, the treatment methods of closed calcaneal fracture are more and more abundant, but the incidence of incision complications after surgery has been high, causing great trouble to patients. There are always controversies on the factors and pre-vention strategies of incision complications after closed calcaneal fracture surgery. Doctors who are inexperienced also have many blind spots on the occurrence and prevention of incision complica-tions. This article reviews the related factors and prevention strategies of incision complications af-ter closed calcaneal fracture surgery.
文章引用:李刚, 刘永辉, 王子豪, 王涛. 闭合性跟骨骨折术后发生切口并发症的相关因素及预防策略[J]. 临床医学进展, 2023, 13(6): 9611-9618. https://doi.org/10.12677/ACM.2023.1361345

参考文献

[1] Allegra, P.R., Rivera, S., Desai, S.S., et al. (2020) Intra-Articular Calcaneus Fractures: Current Concepts Review. Foot & Ankle Orthopaedics, 5, Article ID: 2473011420927334. [Google Scholar] [CrossRef] [PubMed]
[2] Brauer, C.A., Manns, B.J., Ko, M., et al. (2005) An Economic Evaluation of Operative Compared with Nonoperative Manage-ment of Displaced Intra-Articular Calcaneal Fractures. The Journal of Bone & Joint Surgery, 87, 2741-2749. [Google Scholar] [CrossRef
[3] Cursaru, A., Crețu, B., Șerban, B., et al. (2022) Minimally Invasive Treatment and Internal Fixation vs. Extended Lateral Approach in Calcaneus Fractures of Thalamic Interest. Experimental and Therapeutic Medicine, 23, Article No. 196. [Google Scholar] [CrossRef] [PubMed]
[4] Li, Y., Bao, R.-H., Jiang, Z.-Q. and Wu, H.-Y. (2016) Complications in Operative Fixation of Calcaneal Fractures. Pakistan Journal of Medical Sciences, 32, 857-862. [Google Scholar] [CrossRef] [PubMed]
[5] Hwang, K., Son, J.S. and Ryu, W.K. (2018) Smoking and Flap Survival. Plastic Surgery, 26, 280-285. [Google Scholar] [CrossRef] [PubMed]
[6] Gabriel, L., Ted, T., Ryan, V., et al. (2022) Soft Tissue Complica-tions Following Extensile Lateral Compared with Minimally Invasive Surgical Approaches in the Operative Treatment of Calcaneus Fractures. Canadian Journal of Surgery, 65, E792-E797.
[7] Kim, J.H. and Patel, S. (2017) Is It Worth Discriminating Against Patients Who Smoke? A Systematic Literature Review on the Effects of Tobacco Use in Foot and Ankle Surgery. The Journal of Foot and Ankle Surgery, 56, 594-599. [Google Scholar] [CrossRef] [PubMed]
[8] Su, J. and Cao, X.C. (2017) Risk Factors of Wound Infection after Open Reduction and Internal Fixation of Calcaneal Fractures. Medicine, 96, e8411. [Google Scholar] [CrossRef
[9] 庄泽, 陈郁鲜, 梁堂钊, 等. 跟骨骨折内固定术后切口愈合不良影响因素分析[J]. 中国骨与关节损伤杂志, 2018, 33(2): 206-208.
[10] Koski, A., Kuokkanen, H. and Tukiainen, E. (2005) Postoperative Wound Complications after Internal Fixation of Closed Calcaneal Fractures: A Ret-rospective Analysis of 126 Consecutive Patients with 148 Fractures. Scandinavian Journal of Surgery, 94, 243-245. [Google Scholar] [CrossRef] [PubMed]
[11] 王利新. 80例跟骨骨折外侧延长L形切口并发症非手术相关危险因素分析[J]. 武警后勤学院学报(医学版), 2017, 26(8): 689-690.
[12] Vosoughi, A.R., Shayan, Z., Salehi, E., et al. (2020) Agreement between Sanders Classification of Intraarticular Calcaneal Fractures and Assessment during the Surgery. Foot and Ankle Surgery, 26, 94-97. [Google Scholar] [CrossRef] [PubMed]
[13] Rubino, R., Valderrabano, V., Sutter, P.M. and Regazzoni, P. (2009) Prognostic Value of Four Classifications of Calcaneal Fractures. Foot & Ankle International, 30, 229-238. [Google Scholar] [CrossRef
[14] 赵星, 赵猛, 关韶勇, 等. 闭合性跟骨骨折术后深部感染的危险因素[J]. 中华创伤骨科杂志, 2019, 21(1): 28-33.
[15] Belmont Jr., P.J., Goodman, G.P., Waterman, B.R., Bader, J.O. and Schoenfeld, A.J. (2014) Thirty-Day Postoperative Complications and Mortality Following Total Knee Arthroplasty: Incidence and Risk Factors among a National Sample of 15,321 Patients. The Journal of Bone & Joint Surgery, 96, 20-26. [Google Scholar] [CrossRef
[16] Lu, K., Ma, T., Yang, C., Qu, Q. and Liu, H. (2022) Risk Prediction Model for Deep Surgical Site Infection (DSSI) Following Open Reduction and Internal Fixation of Displaced In-tra-Articular Calcaneal Fracture. International Wound Journal, 19, 656-665. [Google Scholar] [CrossRef] [PubMed]
[17] 范新星, 沈彦, 谢文龙. 跟骨外侧延长L形切口并发症的危险因素分析[J]. 中国骨伤, 2017, 30(4): 339-344.
[18] Ding, L., He, Z.M. Xiao, H.J., Chai, L.Z. and Xue, F. (2013) Risk Factors for Postoperative Wound Complications of Calcaneal Fractures Following Plate Fixation. Foot & Ankle International, 34, 1238-1244. [Google Scholar] [CrossRef] [PubMed]
[19] 周明平, 郑强, 邹光翼. 跗骨窦切口微型钢板联合空心钉内固定治疗跟骨骨折的并发症及影响因素分析[J]. 中华全科医学, 2022, 20(7): 1122-1125+1134.
[20] Soni, A., Vollans, S., Malhotra, K. and Mann, C. (2014) Association between Smoking and Wound Infection Rates Following Calcaneal Fracture Fixation. Foot & Ankle Specialist, 7, 266-270. [Google Scholar] [CrossRef] [PubMed]
[21] 姚小涛, 陈志达, 林斌, 等. 跟骨关节内骨折术后疗效及并发症分析[J]. 中国骨与关节损伤杂志, 2019, 34(4): 421-423.
[22] Backes, M., Schepers, T., Beerekamp, M.S.H., et al. (2014) Wound Infections Following Open Reduction and Internal Fixation of Calcaneal Fractures with an Extended Lat-eral Approach. International Orthopaedics, 38, 767-773. [Google Scholar] [CrossRef] [PubMed]
[23] 姚琦, 仇永辉, 祝孟海, 等. 跟骨骨折术后切口并发症的分析及预防策略[J]. 中华创伤骨科杂志, 2015, 17(9): 757-760.
[24] Wang, H., Pei, H., Chen, M. and Wang, H. (2018) Incidence and Predictors of Surgical Site Infection after ORIF in Calcaneus Fractures, a Retrospective Cohort Study. Journal of Orthopaedic Surgery and Research, 13, Article No. 293. [Google Scholar] [CrossRef] [PubMed]
[25] 张道前, 邵卫东, 周业松, 刘开祥. 改良外侧“L”型切口治疗Sanders Ⅳ型跟骨骨折的效果观察[J]. 创伤外科杂志, 2019, 21(6): 455-458.
[26] 赵德源, 秦入结, 陆向君, 等. 跗骨窦入路与外侧L形切口入路治疗单侧Sanders II、III型跟骨骨折的疗效比较[J]. 创伤外科杂志, 2021, 23(8): 599-602+608.
[27] Nosewicz, T.L., Dingemans, S.A., Backes, M., et al. (2019) A Systematic Review and Me-ta-Analysis of the Sinus Tarsi and Extended Lateral Approach in the Operative Treatment of Displaced Intra-Articular Calcaneal Fractures. Foot and Ankle Surgery, 25, 580-588. [Google Scholar] [CrossRef] [PubMed]
[28] 蔺伟, 黄素芳, 王朝亮, 等. 垂直8字紧密缝合对跟骨骨折术后切口愈合的影响[J]. 中国矫形外科杂志, 2022, 30(12): 1130-1133.
[29] 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[J]. 实用骨科杂志, 2017, 23(2): 185-187.
[30] Qin, S., Zhu, Y., Meng, H., et al. (2022) Relationship between Surgeon Volume and the Risk of Deep Surgical Site Infection (DSSI) Following Open Reduction and Internal Fixation of Displaced In-tra-Articular Calcaneal Fracture. International Wound Journal, 19, 1092-1101. [Google Scholar] [CrossRef] [PubMed]
[31] Driessen, M.L.S., Verstappen, C., Poeze, M., et al. (2022) Treatment of Displaced Intra-Articular Calcaneal Fractures: A Single-Center Experience Study with 20 Years Follow-up. Injury, 53, 3535-3542. [Google Scholar] [CrossRef] [PubMed]
[32] Rau, A.S., Reinikovaite, V., Schmidt, E.P., et al. (2017) Elec-tronic Cigarettes Are as Toxic to Skin Flap Survival as Tobacco Cigarettes. Annals of Plastic Surgery, 79, 86-91. [Google Scholar] [CrossRef
[33] Hao, S., Liu, Y., Yu, M., et al. (2022) The Efficacy of Tar-geted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures. Evidence-Based Complemen-tary and Alternative Medicine, 2022, Article ID: 1294416. [Google Scholar] [CrossRef] [PubMed]
[34] 陈晓俊, 郭骏飞, 贾会扬, 等. 骨折相关张力性水泡形成机制及治疗的研究进展[J]. 中华创伤杂志, 2021, 37(9): 848-854.
[35] 李博, 孙立, 韩伟, 等. 外侧延长“L”形切口治疗跟骨骨折常见并发症及相关因素分析[J]. 中国矫形外科杂志, 2017, 25(2): 178-180.
[36] Alajmi, T., Sharif, A.F., Majoun, M.A., et al. (2022) Minimally Invasive Sinus Tarsi Approach for Open Reduction and Internal Fixation of Cal-caneal Fractures: Complications, Risk Factors, and Outcome Predictors. Cureus, 14, e21791. [Google Scholar] [CrossRef] [PubMed]
[37] Shen, L., Wang, Q., Chen, J., et al. (2022) Risk Factor of Postoperative Incision Infection after Plate Internal Fixation of Calcaneal Fractures: A Retrospective Study. BMC Musculoskeletal Dis-orders, 23, 1091.
[38] 张家乐, 陈鹏涛, 梁远, 等. 跗骨窦入路开放复位内固定累及关节跟骨骨折[J]. 中国矫形外科杂志, 2022, 30(14): 1328-1330+1334.
[39] 郝明, 龚龙, 刘义辉, 张立新. 跟骨骨折术后切口愈合不良的防治体会[J]. 中国骨与关节损伤杂志, 2015, 30(S1): 113-114.
[40] Shannon, S.F., Houdek, M.T., Wyles, C.C., et al. (2017) Allgöwer-Donati versus Vertical Mattress Suture Technique Impact on Perfusion in Ankle Fracture Surgery: A Randomized Clinical Trial Using Intraoperative Angiography. Journal of Orthopaedic Trauma, 31, 97-102. [Google Scholar] [CrossRef
[41] 刘元富, 左红艳, 陈小刚, 等. 减张皮内缝合预防跟骨骨折术后切口愈合不良[J]. 临床骨科杂志, 2021, 24(3): 330.
[42] Prabhakar, G., Bullock, T.S., Martin, C.W., et al. (2021) Skin Closure with Surgical Staples in Ankle Fractures: A Safe and Reliable Method. International Orthopaedics, 45, 275-280. [Google Scholar] [CrossRef] [PubMed]
[43] Zhang, Z., Wang, Z., Zhang, Y., Qiu, X. and Chen, Y. (2018) Risk Factors for Increased Postoperative Drainage of Calcaneal Fractures after Open Reduction and Internal Fixation: An Observational Study. Medicine, 97, e11818. [Google Scholar] [CrossRef
[44] Cai, L., Mei, Y., Chen, C., et al. (2022) Comparison of Vacuum Sealing Drainage and Conventional Drainage for Postoperative Drainage in Closed Calcaneal Fracture: A Ran-domized Controlled Trial. Injury, 53, 777-783. [Google Scholar] [CrossRef] [PubMed]
[45] Bibbo, C., Siddiqui, N., Fink, J., et al. (2019) Wound Coverage Options for Soft Tissue Defects Following Calcaneal Fracture Management (Operative/Surgical). Clinics in Podiatric Medicine and Surgery, 36, 323-337. [Google Scholar] [CrossRef] [PubMed]