Donati―Allgower方法缝合跟骨骨折手术切口疗效分析.docVIP

Donati―Allgower方法缝合跟骨骨折手术切口疗效分析 　　[摘要] 目的 探讨Donati-Allgower缝合法在跟骨骨折手术切口缝合时的临床效果。 方法 选择2011年4月～2013年4月63例跟骨骨折患者，随机采用DA缝合法及垂直褥式缝合法行切口一期闭合。DA缝合法（A组）31例，垂直褥式缝合法32例（B组），观察术后至术后1个月切口周围情况。观察指标包括疗效、皮缘血运、肿胀、感染、坏死等愈合相关临床指征。 结果 A组临床疗效优良率为93.5%，B临床疗效优良率为87.5%，两组比较差异并无统计学意义（x2=0.15，P0.05）。A组术后切口均获甲级愈合，2例出现明显皮缘缺血无坏死，无伤口感染等并发症发生，B组7例切口皮缘出现缺血表现，后期愈合良好，1例坏死、1例感染行其他治疗。A组并发症发生率（6.5%）明显低于B组（28.1%）（P0.05）。 结论 DA缝合法在跟骨骨折手术切口缝合时，能保护皮缘血运、避免组织缺血坏死、降低并发症发生率，值得临床推广使用。 　　[关键词] 跟骨骨折；Donati-Allgower缝合法；并发症；手术治疗 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 2095-0616（2015）14-189-03 　　Analysis of therapeutic effect of Donati-Allgower method in suturing of calcaneal fractures incision 　　GE Shuanglei ZHANG Yakui WANG Xuefei 　　Department of Trauma Orthopedics， Beijing Luhe Hospital Affiliated to Capital Medical University， Beijing 101149， China 　　[Abstract] Objective To investigate the clinical effect of Donati-Allgower method in suturing of calcaneal fractures incision. Methods 63 cases of calcaneal fracture patients from 2011 April to 2013 April were selected， they were treated with lateral calcaneal skin L shaped incision and randomly used DA suture and vertical mattress suture. And circumstances around the incision in 31 cases with DA suture （A group）， 32 cases with vertical mattress suture （group B） were observed after 1 month after surgery， the outcome measures were observed， included effect， blood supply in the skin flap， swelling， infection， necrosis and other union-related clinical indications. Results The good and excellent rate of group A was 93.5%， and group B was 87.5%， the difference was not statistically significant （x2=0.15，P0.05）. Group A were healed well， 2 cases were mild swelling， there was no significant skin flap ischemia and necrosis， and no wound infection occurred. However， 4 cases in the Group B had ischemic performance in the skin flap， late healed well，1 case of necrosis and 1 case of infection in the line other treatment. The complication rate of group A （6.5%） was signifi