Allgower-Donati缝合法与间断垂直褥式缝合法对跟骨骨折患者切口愈合及瘢痕形成的影响观察

The effects of Allgower-Donati suture and interrupted vertical mattress suture on incision healing and scar formation in patients with calcaneal fractures

目的探讨Allgower-Donati缝合法与间断垂直褥式缝合法对跟骨骨折外侧L型切口切开复位内固定治疗术后切口愈合及瘢痕形成的影响。方法回顾性分析2016年10月至2019年10月我院收治的103例跟骨骨折患者临床资料,根据切口缝合方案不同分为观察组(Allgower-Donati缝合)62例和对照组(间断垂直褥式缝合)41例,比较两组围术期指标、骨折治疗效果、切口愈合等级、切口并发症及瘢痕大小。结果观察组术后引流时间和切口愈合时间低于对照组,Maryland足部评分优良率高于对照组,切口愈合等级分布优于对照组,皮缘缺血和皮肤坏死发生率低于对照组(P<0.05);两组术后瘢痕均缩小,且观察组术后1、3、6月瘢痕均小于对照组(P<0.05)。结论Allgower-Donati缝合法用于跟骨骨折外侧L型切口切开复位内固定治疗有利于促进切口愈合并减少并发症和瘢痕形成,与间断垂直褥式缝合法相比可明显提升治疗效果。

Objective To investigate the effects of Allgower-Donati suture and interrupted vertical mattress suture method on incision healing and scar formation after open reduction internal fixation with lateral L-shaped incision for calcaneal fractures.Methods The clinical data of 103 patients with calcaneal fractures admitted to our hospital from October 2016 to October 2019 were retrospectively analyzed.The patients were divided into observation group(Allgower-Donati suture,n=62)and control group(interrupted vertical mattress suture,n=41)according to different incision suture schemes.The clinical information were collected in the two groups,and the perioperative indicators,fracture treatment effect,incision healing grade,incision complications and scar size were compared between the two groups.Results The postoperative drainage time and incision healing time in the observation group were significantly shorter than those in the control group(P<0.05).The excellent and good rates of Maryland foot score in the two groups were 91.94%and 78.05%,respectively(P<0.05).The distribution of incision healing grade in the observation group was obviously better than that in the control group(P<0.05).The incidence rates of skin marginal ischemia and skin necrosis in the observation group were significantly lower than those in the control group(P<0.05).The postoperative scar size was significantly reduced in both groups(P<0.05),and the scar size after 1 month,3 months and 6 months of surgery in the observation group was shorter than that in the control group(P<0.05).Conclusion Allgower-Donati suture in open reduction internal fixation with lateral L-shaped incision for calcaneal fractures can help to promote the incision healing and reduce the complications and scar formation.Compared with interrupted vertical mattress suture,it can significantly improve the treatment effects.