低能开放性胫骨骨干骨折的原发性和延迟原发性伤口闭合:随机对照研究。

Q4 Medicine
West African journal of medicine Pub Date : 2024-12-30
A Adedire, K S Oluwadiya, A Ajibade
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引用次数: 0

摘要

背景:传统上,尤其是在现代抗生素出现之前,延迟一期和二期伤口愈合通常用于治疗开放性骨折。尽管抗生素的可用性,初级伤口关闭仍然不经常使用,甚至治疗低能量开放性胫骨干骨折,特别是在发展中国家。材料和方法:本研究招募了64例gustilloanderson I型和II型胫骨骨折患者,进行随机前瞻性干预研究,比较初次和延迟初次伤口愈合的感染率、伤口愈合时间、住院时间和治疗费用。我们使用randomization.com网站上生成的随机化计划,将68名患者随机分为两组,每组34名参与者。每个随机数字都装在一个密封的棕色信封里,按顺序编号。将临床信息和临床发现录入形式表格,并对所得数据进行分析。结果:54例(84.4%)为gustillo - anderson II型。初次创面愈合的感染率(9.6%)高于延迟初次创面愈合的感染率(3.0%)。初次创面愈合的平均创面愈合时间为14.8(±3.8)天,明显短于延迟创面愈合的16.1(±2.0)天(p= 0.08)。此外,初次伤口愈合患者的平均住院时间(4.1±3.6)天短于延迟伤口愈合患者的平均住院时间(4.7(±1.3)天);p值为0.37。原发性伤口愈合的平均治疗费用(N34,487±4911.4)显著低于延迟性伤口愈合的平均治疗费用(n40,536±1709.0),p值为0.01。结论:与延迟一期缝合相比,低能量开放性胫骨干骨折的一期缝合更具成本效益,且伤口愈合时间更短。因此,即使在低收入和中等收入国家,对于低能性胫骨干骨折也应采用初级伤口闭合。关键词:开放性骨折,胫骨干,伤口闭合,处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary and Delayed Primary Wound Closure in Low Energy Open Tibia Shaft Fracture: Randomized Controlled Study.

Background: Traditionally, delayed primary and secondary wound closure are commonly used for the treatment of open fractures especially before the advent of modern antibiotics. Despite the availability of antibiotics, primary wound closure is still not frequently used even for the treatment of low-energy open tibia shaft fractures especially in developing countries.

Materials and methods: Sixty-four patients with GustiloAnderson type I and II tibia fractures were recruited for this randomized prospective intervention study to compare the infection rate, duration of wound healing, duration of hospital stay, and cost of treatment between primary and delayed primary wound closure. We randomized 68 patients into two blocks of 34 participants each using a randomization plan generated on the website, randomization.com. Each random number in a sealed serially numbered brown envelope. Clinical information and clinical findings were entered into a proforma, and data obtained were analyzed.

Results: The majority of cases, 54 (84.4%), were Gustilo-Anderson type II. The infection rate was higher for primary wound closure (9.6%) than for delayed primary wound closure (3.0%). The mean duration of wound healing was 14.8 (±3.8) days for primary wound closure, which was significantly shorter than the 16.1 (±2.0) days recorded for delayed wound closure (p= 0.08). Also, the mean duration of hospital stay was shorter for patients treated with primary wound closure (4.1 ±3.6) days than for delayed wound closure patients 4.7 (±1.3); with a p value of 0.37. The mean cost of treatment for primary wound closure (N34,487 ±4911.4) was significantly less than that for delayed primary wound closure (N 40,536 ±1709.0), with a p-value of 0.01.

Conclusion: Primary wound closure for low-energy open tibia shaft fractures is both more cost-effective and associated with a shorter time to wound healing compared to delayed primary closure. Therefore, primary wound closure should be used for low energy tibia shaft fracture even in low and middle-income countries. KEY WORDS: Open fracture, Tibia shaft, Wound closure, Management.

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West African journal of medicine
West African journal of medicine Medicine-Medicine (all)
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