跟骨外侧切口愈合不良的原因分析及预防措施.docVIP

精品论文 参考文献 跟骨外侧切口愈合不良的原因分析及预防措施 夏波 王艳梅 徐献伦 赵强 　　（济宁市第一人民医院急诊创伤外科 山东济宁 272000） 　　【摘要】目的 回顾外侧切口治疗跟骨骨折的手术方法及早期切口并发症，分析切口愈合不良的原因及预防措施。方法 选取2008年9月至2013年8月期间采用外侧切口切开复位内固定治疗的跟骨骨折59足，对手术操作、围手术期管理及术后疗效等进行分析，探讨引起外侧切口愈合不良的原因及预防措施。结果 本组患者均获得随访，随访时间4 ～18个月。共出现切口愈合不良3足。其中浅表感染2足，换药后创面愈合。1例患者出现深部感染，内固定外露，给予皮瓣手术覆盖创面。结论 合适的手术时机，适当的手术入路，术中轻柔操作，避免损伤皮瓣血运，术后注意切口引流，积极治疗合并症，都是降低跟骨外侧切口愈合不良几率的预防措施。 　　【关键词】跟骨骨折 内固定 切口愈合不良 　　【中图分类号】R619 【文献标识码】A 【文章编号】2095-1752（2014）01-0154-02 　　Analysis and preventive measures to poor healing for lateral incision of calcaneal fractures 　　XIA Bo WANG Yan-mei XU Xian-lun Zhao Qiang 　　（Department of Emergency and Traumatology, Jining First Peoplersquo;s Hospital，Jining 272000，China） 　　【Abstract】Objective To evaluate the operational manner and early wound complications of open reduction and internal fixation of calcaneal fractures through lateral approach and to study the reasons and prevention measures of poor healing of incision. Methods From September 2008 to August 2013 , 59 feet with calcaneal fractures were fixed with locking plates through the lateral approach. The reasons and prevention measures of poor healing of incision were investigated by analyzing operative procedure, periprocedural management and postoperative effect. Results Follow-up ranged from 4 to 18 months. Incision dehiscence occured in three cases, in which two cases had superficial wound infection and the incision was healed bv dressing , one case which had deep wound infection and Internal fixation was exposed was healed by covering the wound surface with flap surgery. Conclusion Appropriate surgical timing and incision, gentle operation, blood supply protection of flap, wound drainage and positive treatment of complications might be measures to reduce the rate of poor healing of incision of calcaneal fractures through lateral approach. 　　【Key words】 Calcaneal fractures Internal fixation Poor incision hea