高位腓动脉穿支皮瓣治疗跟骨骨折术后感染的研究

发布时间：2018-03-01 03:04

本文关键词： 高位腓动脉穿支皮瓣跟骨骨折感染治疗价值　出处：《中华医院感染学杂志》2017年20期 　论文类型：期刊论文

【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%(P0.05)。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(P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the level of peroneal artery perforator flap closed calcaneal fracture internal fixation postoperative incision deep treatment of tissue infection. Methods Retrospective analysis of 40 cases of calcaneus in May 2010 -2015 year in August admitted to the hospital after fracture surgery incision infection in patients with deep tissue infection; 20 cases were high of peroneal artery perforator flap treatment (A group), sural neurovascular flap and 20 cases were treated with traditional (group B); in the two group were underwent flap wound infection and purulent secretion culture (preoperative training), and the two groups were also collected inflammatory granulation tissue culture (during training). Analysis of the patient's etiology, cultivation of determine the pathogen to compare the value of preoperative and intraoperative, cure rate and quality of flap flap infection were compared between the two groups. The two group of preoperative and intraoperative culture of Staphylococcus aureus and Staphylococcus epidermidis were rare, and A positive rate of 100% was significantly higher than the preoperative 75% (P0.05) A postoperatively. 20 cases were cured, the cure rate was 100%, B group 13 cases were cured, the cure rate was 65%; there was significant difference between two groups (P0.05). The quality evaluation of advanced A flap were excellent in 19, good in 1, poor in 0 cases, B group excellent in 9, good in 2, poor in 9 cases; there was significant difference between two groups (P0.05). Open reduction and plate fixation after incision deep tissue infection. Conclusion high peroneal artery perforator flap for the treatment of closed fracture of calcaneus sural neurovascular flap has better effect than the traditional.

【作者单位】：苏州大学附属第二医院骨科;保定市第一中心医院骨五科;
【基金】：保定市科技局支撑基金资助项目(16ZF068)
【分类号】：R658.3

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