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在常规上肢手术中关闭之前的伤口灌:伤口并发症有区别吗?

Marco Foreman1, Isabella Amador1, Arman Tabarestani1

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Hand (New York, N.Y.)
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在上肢手术关闭前进行常规的伤口灌并不能减少并发症. 放弃灌可以提高手术室的效率,

关键词:
肘部手术手的手术运营成本伤口灌

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科学领域:

  • 骨科手术
  • 手术部位感染
  • 伤口管理

背景情况:

  • 在常规的骨科上肢手术中,关于关闭前伤口灌的必要性没有共识.
  • 如果被证明有效,关闭前的伤口灌可能会节省时间和成本.

研究的目的:

  • 评估关闭前伤口灌在常规上肢手术中减少伤口并发症的有效性.

主要方法:

  • 从2013年至2022年进行软组织上肢手术的1425名成年患者的回顾性审查.
  • 排除标准包括同时发生的撕裂,穿透的伤害,开放的骨折或未知的灌技术.
  • 主要结果:对灌和非灌伤口的伤口并发症率进行比较;用于控制混因子的多变量逻辑回归.

主要成果:

  • 在2. 9%的患者中发生了伤口并发症.
  • 在关闭之前的灌与双变量 (3.5%对1. 8%,P=0. 070) 或多变量分析 (OR:1. 88,95% CI 0. 88-4. 04,P=0. 08) 中的伤口并发症发生率的降低无关.
  • 对年龄,性别,BMI,手术时间,先前手术,糖尿病,烟草使用,皮质类固醇使用和免疫抑制剂使用进行调整分析.

结论:

  • 关闭前的伤口灌与术后伤口并发症率的统计学上显著差异无关.
  • 为了提高手术室的效率和节省成本, 外科医生可能会考虑不进行关闭前的灌.