越多越好吗？评估早期手术清创对Morel-Lavallee病变的影响

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-02-06 DOI:10.1016/j.amjsurg.2025.116238

Jose E. Barrera , Shuyan Wei , Chioma G. Obinero , Catherine Tang , Emily Cao , Charles Osamor III , Jessica R. Nye , Gabrielle E. Hatton , Mohin Bhadkamkar , Yuewei Wu-Fienberg , Lillian S. Kao , Matthew R. Greives

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引用次数: 0

摘要

morel - lavallee病变（MLL）是闭合性脱手套损伤，感染后通常需要复杂的处理。与观察相比，我们评估早期清创是否能降低感染风险。方法对2012年至2022年成人MLL患者进行单中心回顾性研究，分析诊断、感染、人口统计学和医院预后。在48小时内进行清创的患者与最初观察的患者进行比较。结果219例患者中，79例（36%）首次行手术清创，140例（64%）首次观察。总感染率为9%。手术组住院时间更长(14天vs7天，p <；0.001)和更多的清创(2vs0, p <；0.001)。手术组感染率较高（13.9%vs 6.4%, p = 0.064），但差异无统计学意义。多变量分析发现，较高的BMI、髋关节位置和红细胞输注是重要的感染预测因素。结论两组患者感染率无显著差异，但存在多种危险因素。需要提高认识和更好的研究设计来改进MLL管理指南。

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Is more better? Evaluating the impact of early surgical debridement on Morel-Lavallee lesions

Introduction

Morel-Lavallee lesions (MLL) are closed degloving injuries, often requiring complex management when infected. We evaluated if early debridement reduces infection risk compared to observation.

Methods

We conducted a single-center retrospective study of MLL in adults from 2012 to 2022, analyzing diagnoses, infection, demographics, and hospital outcomes. Patients undergoing debridement within 48 h were compared to those initially observed.

Results

Of 219 patients, 79 (36 %) underwent initial surgical debridement, and 140 (64 %) were initially observed. The overall infection rate was 9 %. The surgery group had longer hospital stays (14vs7 days, p < 0.001) and more debridements (2vs0, p < 0.001). While infection rate was higher in the surgery group (13.9%vs6.4 %, p = 0.064), this difference was not statistically significant. Multivariate analysis identified higher BMI, hip location, and RBC transfusions as significant infection predictors.

Conclusion

No significant differences in infection rates were found, but several risk factors were identified. Greater awareness and better study designs are needed for improved MLL management guidelines.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.