旋股外动脉穿支皮瓣修复手外伤术后感染危险因素分析

Analysis of infection factors for postoperative infection after repairing hand trauma by perforator flap with external circumflex femoral artery

目的探讨旋股外动脉穿支皮瓣修复手外伤术后出现感染的影响因素。方法回顾性分析2015年7月-2021年7月采用旋股外动脉穿支皮瓣修复的90例手外伤患者临床资料。采用单因素分析术后感染的影响因素。对90例患者具体临床信息进行评估,对比性别、年龄分布、住院时间、手术时间、术中出血量、术前抽烟情况;术前血糖情况及BMI值等进行综合分析。结果本组90例出现感染38例,年龄17~44岁,平均(38±1.3)岁,女性和男性比为1∶2.8,感染率42%。本组年龄>40岁者48例,<40岁者32例。术前抽烟情况和手术时间对术后感染有影响,具有统计学意义(P<0.01),证明两者是感染危险因素。结论尽量缩短旋股外动脉穿支皮瓣手术时间可降低感染率,并对术前抽烟的手外伤患者需要预防穿支皮瓣术后感染。

objective To investigate the influencing factors of infection after repair hand trauma by perforator flap with external circumflex femoral artery.Methods From July 2015 to July 2021,90 patients with hand trauma treated by perforator flap of external circumflex femoral artery were retrospectively analyzed.The specific clinical information of 90 patients was evaluated,including gender ratio,age distribution,hospitalization time,operation time,intraoperative blood loss,preoperative smoking status,preoperative blood glucose,and BMI were comprehensively analyzed.Results Among the 90 patients,32 were female,58 were male,48 were older than 40 years old,and 32 were younger than 40 years old.There were 38 cases of infection,aged 17-44 years(38±1.3),and the female to male ratio was 1∶2.8.Preoperative smoking and operation time had statistical significance on postoperative infection after Perforator flap of external circumflex femoral artery repairing(P<0.01),both of which were risk factors for infection.Conclusion Perforator flap of external circumflex femoral artery repair is a mature surgical method for hand trauma,which can reduce intraoperative bleeding and achieve good hand appearance.In terms of infection,taking into account the smoking status of patients before surgery and the control of operation time can better improve the infection situation after surgery.