全膝人工关节置换伤口并发症53例分析

全膝置换术后伤口愈合并发症的处置【摘要】研究背景 全膝置换术术后皮肤损伤可能危及假体的功能。本研究的目的是为关节外科医师提供处置全膝关节置换术后伤口愈合并发症的方法。提供一种处置这些伤口的原则。 资料与方法 本项研究包括首次全膝置换术术后回顾性分析1998-01/2006-12上海长征医院骨科关节外科部收治的53例(69膝)发生全膝置换后伤口并发症患者的临床资料。伤口皮肤问题包括皮肤红肿、切口裂开、局部血肿、皮肤坏死和深部感染，分别采取相应的处理措施。其中58膝进行局部皮肤护理；6膝进行清创和二期闭合；皮肤软组织缺损的基本处置中3膝行局部肌瓣移植，1膝行筋膜皮瓣移植，1膝行筋膜皮瓣和皮肤游离移植。平均随访1.9年，所有伤口均愈合良好。提示治疗全膝置换后伤口愈合并发症，应该根据病情采取相应的处置方法。

Wound-healing complications following total knee arthroplasty in 53 patients

Clinical data of 53 patients (69 knees), who were treated at the Division of Joint Surgery, Department of Orthopaedics, Changzheng Hospital from January 1998 to December 2006, were retrospectively analyzed. These patients suffered from wound-healing complications following total knee arthroplasty. Wound skin problems included skin flare, disruption of wound, local hematoma, skin necrosis and deep infection. Local wound care was performed in 58 knees, debridement and secondary closure in 6 kness, and primary management of the soft tissue defect was achieved with local muscle flaps in 3 knees, with the fasciocutaneous flap in 1 knee, and with fasciocutaneous flap and skin grafting in 1 knee. Mean follow-up was 1.9 years. All wound was healed well. It is indicated that corresponding management should be used for treating wound-healing complications following total knee arthroplasty.