红光联合皮肤缝合器用于跟骨皮肤切口的疗效观察

目的探讨红光照射联合皮肤缝合器应用于跟骨骨折手术切口的疗效。方法将我院2017年1月—2019年4月收治的跟骨骨折患者资料进行回顾性研究,按照纳入及排除标准,纳入患者135例,根据缝合及术后处理方式不同分为3组,A组(红光照射+钉合组)、B组(钉合组)和C组(缝合组),拆钉或拆线后平均随访3个月,分别对3组缝合速度、切口渗出及愈合时间,皮缘坏死、炎性反应、切口裂开、钢板外露、切口感染、过敏反应及术后3个月切口蜈蚣状瘢痕的发生率,术后第2、4天及拆钉(线)时的疼痛程度(采用VAS评分)进行统计学分析。结果A组较B组切口的炎性反应更轻,术后2、4天疼痛程度更低,切口渗出及愈合时间更短,差异有统计学意义(P<0.05)。A组较C组的缝合速度更快,炎性反应更少,皮缘坏死率更低,疼痛程度更轻,切口渗出及愈合的时间更短,蜈蚣症出现的更少,差异有统计学意义(P<0.05)。B组较C组的缝合速度更快,皮缘坏死率更低,拆钉时疼痛程度更轻,蜈蚣症出现的更少,差异有统计学意义(P<0.05)。在切口裂开、钢板外露、切口感染、过敏反应方面,3组结果比较差异无统计学意义(P>0.05)。结论红光照射联合皮肤缝合器应用于跟骨骨折手术切口能够减轻炎性反应、减少皮缘的坏死率、降低疼痛程度、缩短切口渗出及愈合的时间,且能加快缝合速度,降低手术并发症,达到较好的美容效果。

Observation of Curative Effect of red Light Irradiation Combined With Skin Suture Device in Calcaneal Skin Incision

Objective To investigate the effect of red light irradiation combined with skin suture on calcaneal fracture incision.Methods According to the inclusion and exclusion criteria,135 patients with calcaneal fractures were enrolled in our hospital from January 2017 to April 2019.They were divided into three groups according to the difference of suture and post-operative treatment.Group A(red light+nailing group),Group B(nailing group)and Group C(suture group).The average followup time was 3 months after the removal of nails or sutures.The incision exudation and healing time,skin edge necrosis,inflammatory reaction,incision dehiscence,steel plate exposure,incision infection,allergic reaction and incision centipede paralysis scar incidence at 3 months after operation,and the pain degree at 2,4 days after operation and at the time of nail removal(line)were analyzed by VAS score.Results The inflammatory reaction of incision in group A was lighter than that in group B.The degree of pain was lower in 2 and 4 days after operation,and the time of incision exudation and healing was shorter.The difference was statistically significant(P<0.05).Compared with group C,group A had faster suture speed,less inflammatory reaction,lower rate of skin edge necrosis,less pain,shorter time of incision exudation and healing,and fewer centipedes(P<0.05).The suture speed of group B was faster than that of group C,the rate of skin edge necrosis was lower,the degree of pain was lighter and centipede was less in group B than that in group C,the difference was statistically significant(P<0.05).There was no significant difference in incision dehiscence,plate exposure,incision infection and allergic reaction among the three groups(P>0.05).Conclusion The application of red light irradiation combined with skin suture device in calcaneal fracture incision can alleviate inflammatory reaction,reduce the necrosis rate of skin margin,reduce pain degree,shorten the time of incision exudation and healing,accelerate the suture speed,reduce the complications of operation,and achieve better cosmetic effect.