两种技术闭合筋膜切开减张创口的比较△

Comparison of two techniques for closing wound secondary to fasciotomy for decompression

摘要:

[目的]比较使用 NICE 结技术联合负压封闭引流(联合治疗)与钢丝、克氏针牵引(牵引治疗)闭合筋膜切开减张创口的临床效果。[方法]2017 年 3 月—2021 年 3 月，骨筋膜室切开减压患者共 50 个创口。其中，24 创口采用联合治疗，26 创口采用牵引治疗。比较两组围手术期情况、临床效果、费用及患者满意度。[结果]两组患者均顺利完成手术。两组手术时间、切口长度、术中出血量的差异均无统计学意义(P＞0.05)。联合组在术后 48 h 内引流量、切口宽度、切口闭合时间、HCT 和治疗费用显著低于牵引组(P＜0.05)。联合组术后 VAS 评分和并发症率均显著优于牵引组(P＜0.05)。但是两组患者满意度差异无统计学意义(P＞0.05)。[结论]两种治疗各有其优缺点，应依据实际情况选择。

Abstract:

[Objective] To compare the clinical outcomes of Nice knot technique combined with vacuum assisted closure (the com- bined therapy) versus traction with steel wire and Kirschner wire (the traction therapy) for closure of fasciotomy wounds. [Methods] A retro- spective study was conducted on 45 patients (50 wounds) who had fasciotomies from March 2017 to March 2021. Of them, 24 wounds were treated by combined therapy, while the other 26 wounds were treated by the traction therapy. The perioperative documents, cost and patient satisfaction were compared between the two groups. [Results] The operations were successfully completed in both groups. There were no significant differences in operative time, incision length and intraoperative blood loss between the two groups (P＞0.05) . The com- bined group proved significantly inferior to the traction group in terms of drainage volume within 48h, wound width postoperatively and wound closure time, HCT and therapy expense (P＜0.05) , whereas the former was significantly superior to the latter in the postoperative VAS scores and complication rate (P＜0.05) . However, there was no significant difference in patient satisfaction between the two groups (P＞0.05) . [Conclusion] The two techniques have their own advantages and disadvantages, and should be selected according to the actual situation.