Paper Information

Journal:   JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)   JUNE 2014 , Volume 19 , Number 6; Page(s) 495 To 501.
 
Paper: 

REGRESSION ANALYSIS OF CONTROLLABLE FACTORS OF SURGICAL INCISION COMPLICATIONS IN CLOSED CALCANEAL FRACTURES

 
 
Author(s):  WU KAI, WANG CHUANSHUN, WANG QIUGEN, LI HAOQING*
 
* DEPARTMENT OF ORTHOPEDICS, THE FIRST PEOPLE’S HOSPITAL AFFI LIATED TO SHANGHAI JIAO TONG UNIVERSITY, 100 HAI NING ROAD, SHANGHAI 200080, CHINA
 
Abstract: 

Background: In surgeries of closed calcaneal fractures, the lateral L-shaped incision is usually adopted. Undesirable post-operative healing of the incision is a common complication. In this retrospective study, controllable risk factors of incision complications after closed calcaneal fracture surgery through a lateral L-shaped incision are discussed and the effectiveness of clinical intervention is assessed.
Materials and Methods: A review of medical records was conducted of 209 patients (239 calcaneal fractures) surgically treated from June 2005 to October 2012. Univariate analyses were performed of seven controllable factors that might influence complications associated with the surgical incision. Binomial multiple logistic regression analysis was performed to determine factors of statistical significance.
Results: Twenty-one fractures (8.79%) involved surgical incision complications, including 8 (3.35%) cases of wound dehiscence, 7 (2.93%) of flap margin necrosis, 5 (2.09%) of hematoma, and 1 (0.42%) of osteomyelitis. Five factors were statistically significant: The time from injury to surgery, operative duration, post-operative drainage, retraction of skin flap, bone grafting, and patients’ smoking habits. The results of multivariate analyses showed that surgeries performed within 7 days after fracture, operative time>1.5 h, no drainage after surgery, static skin distraction, and patient smoking were risk factors for calcaneal incision complications. The post-operative duration of antibiotics and bone grafting made no significant difference.
Conclusion: Complications after calcaneal surgeries may be reduced by postponing the surgery at least 7 days after fracture, shortening the time in surgery, implementing post-operative drainage, retracting skin flaps gently and for as short a time as possible, and prohibiting smoking.

 
Keyword(s): CALCANEAL FRACTURES, CALCANEUS, INCISION, OPEN REDUCTION WITH INTERNAL FI XATION, SURGICAL COMPLICATION
 
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