摘要
目的探讨创伤骨科非计划再次手术的根本原因,找出有效的预防治疗对策,提高医疗质量,保证医疗安全。方法回顾性分析我科从2015年3月至2017年12月发生的34例非计划再次手术患者的临床资料,总结其发生原因及特点。结果发生非计划再次手术最主要原因是术后感染,占67.6%(23/34),其它包括内固定位置不良2例,术后皮肤软组织缺损2例,肌腱修复术后再次断裂2例,血管损伤术后肢体缺血坏死2例,内固定取出术损伤肌腱1例,术后血肿形成1例,术后异物残留1例。7例开放性创伤截肢术后6例均出现伤口感染。初次手术的级别其中一级手术占5.9%,二级手术占17.6%,三级手术占73.5%,四级手术占2.9%。结论多发创伤,严重开放性骨折,急诊创伤截肢手术可能增加创伤骨科非计划再次手术的风险,非计划再次手术最常见原因是术后感染,加强术者的管理有助于降低非计划再次手术率。
Objective To analyze the reasons of unplanned reoperation of traumatic orthopedics and strengthen its supervision and improve the quality and safety of medical care. Methods Clinical data of 34 patients undergoing unplanned reoperation in our department from Mar 2015 to Dec 2017 were retrospectively analyzed; corresponding causes and characteristics were summarized. Results The main cause of unplanned reoperation was postoperative infection, accounting for 67.6%（23/34）. Other causes included poor position for internal fixation（n=2）, skin and soft tissue defect after surgery（n=2）, re-rupture after tendon repair（n=2）, postoperative limb necrosis after vascular injury（n=2）, tendon injury in removal of internal fixator（n=1）, postoperative hematoma formation（n=1）, and postoperative residual foreign body（n=1）. In seven open wounds, wound infection was found in 6 patients with amputation. Among primary operations, one-level surgery accounted for 5.9%, two-level surgery accounted for 17.6%, three-level surgery for 73.5%,and four-level surgery accounted for 2.9%. Conclusion Multiple trauma, severe open fractures, traumatic amputation in emergency surgery could increase the risk of the unplanned reoperation of traumatic orthopedics, the most common cause of unplanned reoperation in traumatic orthopedics is postoperative infection, to strengthen the management of performer can help reduce unplanned reoperation rate.
作者
刘东
阳波
米宁
罗斌
Liu Dong;Yang Bo;MiNing(Department of Orthopedics,Suining Central Hospital,Suining Sichuan,629000,China)
出处
《生物骨科材料与临床研究》
CAS
2018年第5期49-52,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
再手术
原因分析
对策
创伤骨科
Reoperation
Analysis
Countermeasure
Traumatic orthopedics
