Effect of three-layer close suture and Allgöwer-Donati suture on incision healing after calcaneal fracture surgery
10.3760/cma.j.issn.0253-2352.2019.09.010
- VernacularTitle: 三层紧密缝合法与Allgöwer-Donati缝合法对跟骨骨折术后切口愈合的影响
- Author:
Yingchun WU
1
;
Gang LYU
;
Hui SUN
;
Kaisaier YILIPAN
;
Guxuan WANG
Author Information
1. Department of Orthopaedics, Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Urumqi 830000, China
- Publication Type:Journal Article
- Keywords:
Calcaneus;
Fractures, bone;
Wound closure techniques;
Wound healing
- From:
Chinese Journal of Orthopaedics
2019;39(9):579-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy between three-layer suture and Allgöwer-Donati suture on wound healing.
Methods:From September 2016 to June 2018, patients with Sanders type III calcaneal fracture were randomly divided into two groups: three-layer close suture group (26 cases, 18 males and 8 females, aged 19-48 years, with an average age of 33.69±8.84 years) and Allgöwer-Donati group (26 cases, 19 males and 7 females, aged 19-49 years, with an average age of 32.38±8.45 years). The traditional L-shaped incision was used in all patients. The inflammatory reaction area of incision, skin temperature change at the corner of L-shaped incision line and the healing grade of incision were compared between the two groups.
Results:52 pa-tients were followed up for 6 months. At 2 weeks after operation, the inflammatory reaction area of incision skin in the three-layer close skin suture group (26.46±9.37 mm2) was smaller than that in Allgöwer-Donati suture group (33.16±9.33 mm2). There was a significant difference between the two groups (t=2.584, P=0.013). There was no difference in skin temperature at the corner of L-shaped incision between the two groups before and on the first day after operation. However, the incision skin temperature of the three-layer close suture group on the 2nd and 3rd day after operation[ (36.47±0.33) ℃ and (36.54±0.22) ℃]was higher than that of Allgöwer-Donati group[ (36.20±0.42) ℃ and (36.22±0.43) ℃]. The difference was statistically significant (t=2.61, P=0.01; t= 3.48, P=0.001). There were 25 cases of Class A healing and 1 case of Class B healing in three-layer close suture group, with Class A healing rate of 96.15% (25/26). In Allgöwer-Donati group, there were 22 cases of Class A healing, 1 case of Class B healing, and 3 cases of Class C healing, with Class A healing rate of 84.62% (22/26). Among all grade B healing incisions, 1 case had a small amount of local hemorrhagic exudation in the three-layer close suture group, while 1 case had a black necrosis at the edge of the in-cision, 3 cases had a purulent incision and exposed steel plate in the Allgöwer-Donati group.
Conclusion:In the treatment of L-shaped incision of calcaneal fracture, three-layer close suture is a better method than Allgöwer-Donati suture because of smaller in-flammatory reaction area of incision, higher skin temperature change at the corner of L-shaped incision on the 2nd and 3rd day af-ter operation, higher rate of first-degree healing of incision and slighter incision complications.
