背景在这项研究中,我们的目的是确定伤口裂开率是否有差异,延迟工会,骨不连,以及使用生物可吸收局部抗生素递送系统(LADS)后的意外手术,特别是比较抗生素浸渍的硫酸钙颗粒(Osteoset-T,莱特医疗技术公司,阿灵顿,TN,美国,以下称为珠子)和壳聚糖海绵(SentrexBioSponge,BionovaMedical,日耳曼敦,TN,美国,以下称为海绵),用于治疗急性和慢性四肢伤口。方法我们在1级创伤中心进行了一项回顾性比较队列研究。纳入2010年1月至2017年12月接受珠子或海绵作为手术清创辅助治疗的所有患者。136例患者符合纳入标准.所研究的干预措施是用生物可吸收的LADS治疗的四肢伤口,珠子或海绵。主要结果测量是伤口裂开和需要意外手术。结果在研究队列中的136例患者中,78%(106/136)用珠子处理,22%(30/136)用海绵治疗。136名患者中,50人(37%)出现伤口裂开,49名患者需要意外手术。总的来说,62%(31/50)的伤口裂开患者和67.4%(33/49)的需要意外手术的患者在珠子队列中观察到(分别为p=0.0001和0.025)。然而,在多变量分析中,我们发现伤口开裂和接受意外手术的几率是,分别,与珠子组相比,海绵中发生的可能性高4.9倍(p=0.001)和2.8倍(p=0.021)。结论Sentrex海绵似乎与较高的伤口裂开率和需要意外的手术相比,骨珠。
Background In this study, we aimed to determine if there is a difference in the rates of wound dehiscence, delayed union, nonunion, and unanticipated surgery after the use of bioabsorbable local antibiotic-delivery systems (LADS), specifically comparing antibiotic-impregnated calcium sulfate pellets (Osteoset-T, Wright Medical Technology Inc., Arlington, TN, USA, hereafter referred to as beads) and chitosan sponge (Sentrex BioSponge, Bionova Medical, Germantown, TN, USA, hereafter referred to as sponges) in the management of acute and chronic extremity wounds. Methodology We conducted a retrospective comparative cohort study in the setting of a level 1 trauma center. All patients who received either beads or sponges as an adjunct to surgical debridement from January 2010 to December 2017 were included, and 136 patients met the inclusion criteria. The intervention studied was extremity wounds that were treated with bioabsorbable LADS, either beads or sponges. The main outcome measurement was wound dehiscence and the need for unanticipated surgery. Results Of the 136 patients in the study cohort, 78% (106/136) were treated with beads, and 22% (30/136) were treated with sponges. Of the 136 patients, 50 (37%) experienced wound dehiscence, and 49 patients required unanticipated surgery. Overall, 62% (31/50) of patients with wound dehiscence and 67.4% (33/49) of patients requiring unanticipated surgery were seen in the bead cohort (p = 0.0001 and 0.025, respectively). However, in multivariable analyses, we found that the odds of having wound dehiscence and undergoing unanticipated surgery were, respectively, 4.9 (p = 0.001) and 2.8 (p = 0.021) times more likely to occur in the sponge than in the bead group. Conclusions Sentrex sponges appear to be associated with higher rates of wound dehiscence and the need for unanticipated surgery compared to Osteoset beads.