目标:在接受整形手术的患者中,确定贫血和使用血液制品的具体危险因素,并评估其对患者预后的影响。
方法:对于这项回顾性研究,我们分析了在我院整形外科就诊3年(2018年至2020年)的患者的数据.患有外伤的成年患者,接受重建手术的肿瘤患者,包括需要整形手术进行组织覆盖的软组织感染(STIs)患者。人口和伤害数据,入院特点,外科手术,实验室测试结果,输血事件,和院内并发症从患者记录中提取。
结果:在纳入研究的350名患者中,228(65%)出现创伤,76人(22%)接受了癌症重建手术,46人(13%)患有性传播感染。总的来说,175例(50%)患者出现贫血,和37(11%)接受输血;这些是20(54%),5(14%),和12名(32%)患者的创伤,癌症和性传播感染组,分别。相关的合并症和上下肢手术是贫血的最重要的危险因素。而手术次数和NSTI被确定为输血的危险因素。直接闭合伤口始终是贫血和输血的保护因素。输血与脓毒症的高风险独立相关。伤口并发症,并延长住院时间。
结论:虽然输血是必要的,甚至可以挽救手术患者的生命,血液是一种有限的资源,其使用可能会对患者的预后产生负面影响。因此,正在进行的研究必须专注于提供安全和限制性的临床实践,同时开发可持续和可获得的替代品。
OBJECTIVE: In patients undergoing plastic surgery, to identify specific risk factors for anaemia and use of blood products, and assess their impact on patient outcome.
METHODS: For this retrospective study, data were analysed from patients who attended the Plastic Surgery Department at our hospital over a three-year period (2018 to 2020). Adult patients who presented with traumatic injuries, oncologic patients who underwent reconstructive procedures, and patients with soft tissue infections (STIs) who required plastic surgery for tissue coverage were included. Demographic and injury data, hospital admission characteristics, surgical procedures, laboratory test results, transfusion events, and in-hospital complications were extracted from patient records.
RESULTS: Of the 350 patients included in the study, 228 (65%) presented with trauma, 76 (22%) underwent reconstructive surgery for cancers and 46 (13%) had STIs. In total, 175 (50%) patients developed anaemia, and 37 (11%) received blood transfusions; these were 20 (54%), 5 (14%), and 12 (32%) patients in the trauma, cancer and STI groups, respectively. Associated comorbidities and upper and lower limb surgery were the most significant risk factors for anaemia, while the number of surgeries and NSTIs were identified as risk factors for blood transfusions. Direct wound closure was consistently a protective factor for both anaemia and blood transfusions. Blood transfusions were independently associated with a high risk of sepsis, wound complications, and prolonged hospital stay.
CONCLUSIONS: While transfusions are necessary and even lifesaving in surgical patients, blood is a finite resource and its use may negatively impact patient outcome. Therefore, ongoing research must focus on providing safe and restrictive clinical practices while developing sustainable and accessible alternatives.