摘要
目的探讨高位腓动脉穿支皮瓣对闭合性跟骨骨折切开复位钢板内固定术后切口深部组织感染的治疗价值。方法回顾分析2010年5月-2015年8月医院收治的40例跟骨骨折术后出现切口深部组织感染的患者;20例行高位腓动脉穿支皮瓣治疗感染(A组),20例行传统的腓肠神经营养血管皮瓣治疗(B组);两组均在皮瓣术前行感染创面脓性分泌物培养(术前培养),同时两组术中亦采集炎性肉芽组织培养(术中培养)。分析患者的病原学情况,对比术前及术中培养对判断病原菌的价值,比较两组皮瓣术后感染治愈情况及皮瓣质量。结果两组术前及术中培养以金黄色葡萄球菌及表皮葡萄球菌多见,术中培养阳性检出率为100.00%显著高于术前75.00%(P<0.05)。术后A组治愈20例,治愈率100.00%,B组治愈13例、治愈率65.00%;两组差异有统计学意义(P<0.05)。晚期皮瓣质量评价A组优19、良1、差0例,B组优9、良2、差9例;两组差异有统计学意义(P<0.05)。结论高位腓动脉穿支皮瓣治疗闭合性跟骨骨折切开复位钢板内固定术后切口深部组织感染,疗效优于传统的腓肠神经营养血管皮瓣。
OBJECTIVE To explore the therapeutic value of the higher perforating branch of peroneal artery supplied flap in curing the postoperative incisional deep tissue infections after closed calcaneal fracture internal fixation.METHODS A total of 40 intractable cases which were admitted to the No.1 Central Hospital of Baoding City from May 2010 to Aug.2015 retrospectively analyzed.All the patients were incisional-infected in their deep tissue after calcaneal fracture operations.Among them the wounds of 20 cases（group A）were covered by the higher perforating branch of peroneal artery supplied flaps（HPBPAF）,while the rest 20 cases（group B）were operated with sural neurovascular flaps（SNF）.Both preoperative culture of the wounds,purulent secretion and intraoperative culture of the inflammatory granulation were done on both groups（preoperative culture and intraoperative culture）.The etiology of patients were analyzed.The value of preoperative culture and intraoperative culture were compared,and postoperative infection control and flap quality were observed.RESULTS Staphylococcus aureuand Staphylococcus epidermidis were the most common bacteria in both two groups.Intraoperative culture detection rate was 100%,which was higher than 75% of preoperative culture（P0.05）.For group A,all the infected cases were cured and the cure rate was 100%,and for group B,13 cases were cured and the cure rate was 65%.The difference was significant between the two groups（P0.05）.For the evaluation of late-stage flap quality,19 cases were excellent,1 was good and 0 was poor in group A,.For group B,9 cases were excellent,2 were good and 9 were poor.The difference was also significant between the two groups（P0.05）.CONCLUSION HPBPAF is better than SNF in repairing calcaneal fracture related postoperative infections in deep tissue of incision cite.
作者
胡长青
董启榕
连勇
范虓
孙志平
HU Chang-qing DONG Qi-rong LIAN Yong FAN Xiao SUN Zhi-ping(The Second Affiliated Hospital of Soochozv University, Suzhou, Jiangsu 215004, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4728-4731,共4页
Chinese Journal of Nosocomiology
基金
保定市科技局支撑基金资助项目(16ZF068)
关键词
高位腓动脉穿支皮瓣
跟骨骨折
感染
治疗价值
Higher perforating branch of peroneal artery supplied flaps Caleaneus fractures Infections Therapeutic value
