Predictors of Postoperative Wound Necrosis Following Primary Wound Closure of Open Ankle Fractures
| Autor: | Rami Madanat, Mikko Ovaska, Tatu J. Mäkinen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Open fracture Necrosis medicine.medical_treatment Surgical Wound Therapeutic irrigation Fracture Fixation Internal Fractures Open 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Ankle Injuries Therapeutic Irrigation Aged Retrospective Studies Aged 80 and over 030222 orthopedics Debridement business.industry 030208 emergency & critical care medicine Retrospective cohort study Surgical wound Middle Aged Surgery medicine.anatomical_structure Anesthesia Female Wound closure medicine.symptom Ankle business |
| Zdroj: | Foot & Ankle International. 37:401-406 |
| ISSN: | 1944-7876 1071-1007 |
| DOI: | 10.1177/1071100715609182 |
| Popis: | Background: Most open malleolar ankle fracture wounds can be closed primarily after meticulous debridement. However, the development of wound necrosis following operative treatment of open malleolar ankle fractures can have catastrophic consequences. The aim of this study was to identify risk factors predisposing to postoperative wound necrosis following primary wound closure of open malleolar ankle fractures. Methods: A total of 137 patients with open malleolar ankle fractures were identified. The open fracture wound was primarily closed in 110 of 137 (80%) patients, and postoperative wound necrosis occurred in 18 (16%) of these patients. These patients were compared to the open fracture patients without wound necrosis. Twenty possible risk factors for the development of wound necrosis were studied with logistic regression analysis. Results: The variables that were independently associated with an increased risk for postoperative wound necrosis included ASA class ≥2, Gustilo grade III open injury, and the use of pulsatile lavage at index surgery. Conclusions: Our study showed that ASA class ≥2, Gustilo grade III open injury, and the use of pulsatile lavage at index surgery were the most important factors predisposing to postoperative wound necrosis following primary wound closure of open malleolar ankle fractures. The findings warrant a further study specifically comparing primary and delayed wound closure in patients with Gustilo grade III open malleolar ankle fractures and different ASA classes. Also, the role of pulsatile lavage should be re-evaluated. Level of Evidence: Level III, retrospective comparative series. |
| Databáze: | OpenAIRE |
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