中国骨科手术加速康复切口管理指南

A guideline on the management of incisions for the enhanced recovery after orthopedic surgery in China

骨科手术常见切口并发症包括切口渗液、出血、肿胀、水泡、瘀斑、感染、愈合不良、瘢痕等,切口并发症是影响患者术后加速康复以及非计划再手术的主要原因。因此,加强骨科手术切口管理是实施加速康复的重要环节。通过查阅文献,基于国家卫生计生委公益性行业科研专项《关节置换术安全性与效果评价》项目组数据库大样本数据分析,遵循循证医学原则,经过全国专家组反复讨论,编制本指南,供广大骨科医师在临床工作中参考。本指南包含三部分。第一部分是对切口并发症危险因素的评估,期望减少危险因素,降低切口并发症;第二部分介绍骨科手术切口缝合技术;第三部分是各种常见切口并发症的定义、病因及防治。

Patients undergoing orthopedic surgery usually suffer from incision complications. Multiple factors in preoperative, intraoperative and postoperative periods can contribute to incision exudate, hemorrhage, swelling, blister, ecchymosis,infection, dehiscence and scar. Incision complications are the main causes of unplanned reoperation and difficult to manage,also can significantly prolong enhanced recovery after surgery. Based on the database of the project group for the＂National Health and Family Planning Commission＇s public-benefit project： the safety and effect assessment of joint arthroplasty＂and evidence-based medicine, we compiled this guideline and hope it can give some help to orthopedic surgeons. This guideline contains three parts. The first part is the assessment of risk factors, surgeons should mitigate the risk factors in perioperative period to reduce the likelihood of wound healing complications. The second part introduces incision suture techniques in orthopedic surgery and the last part is the definition, etiology, prevention and treatment of incision complications.