Extended time to wound closure is associated with increased risk of heterotopic ossification of the elbow.
Extended time to wound closure is associated with increased risk of heterotopic ossification of the elbow.
复制标题
伤口闭合时间延长与肘部异位骨化风险增加相关。
DOI：
10.1097/bcr.0b013e318053d378
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Engrav,LorenH
中科院分区：
文献类型：
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作者：
Klein,MatthewB;Logsetty,Sarvesh;Costa,Beth;Deters,Levi;Rue,TessaC;Carrougher,GretchenJ;Pickens,Maureen;Engrav,LorenH
异位骨化（HO）是一种公认的烧伤并发症，可导致肢体功能严重受损。HO的病因和最佳治疗策略仍然难以捉摸。本研究的目的是探讨肘关节创面愈合延迟与HO发展之间的关系。我们进行了一项病例对照研究，以检查伤口关闭延迟与HO发展之间的关系。病例（HO患者）是通过我们的患者登记来确定的，并与年龄、烧伤大小和性别相似的未发生HO的患者相匹配。使用双变量统计比较伤口愈合时间，使用多变量逻辑回归建模基于伤口愈合时间的发生HO的几率。在研究期间，共有45例患者发生肘部HO。与年龄、烧伤大小和性别相匹配的对照组相比，病例中肘部伤口开放时间明显长于对照组（48.7天vs 24.2天，P< 0.01）。多因素logistic回归分析，校正优势比为1.08 （95% CI 1.04 ~ 1.12，P< 0.01）。肘关节伤口闭合时间显著影响异位骨化的发生风险。因此，为了最大限度地降低HO形成的风险，需要增加对关节伤口愈合时间的关注。此外，考虑其他软组织覆盖的选择，如局部皮瓣，包括筋膜或肌肉皮瓣，可能是必要的，在情况下非常深的肘关节，皮肤移植失败的高风险。
Heterotopic ossification (HO) is a well-recognized complication of burn injury that can result in significantly compromised limb function. The etiology and optimal treatment strategy for HO remain elusive. The purpose of this study was to examine the relationship between delay in elbow wound closure and the development of HO. We performed a case-control study to examine the relationship between delay in wound closure and development of HO. Cases (HO patients) were identified using our patient registry and matched with patients of similar age, burn size, and sex who did not develop HO. Time to wound closure was compared using bivariate statistics and the odds for developing HO based on time to wound closure was modeled using multivariate logistic regression. During the study period, a total of 45 patients developed elbow HO. When compared with controls matched for age, burn size, and sex, elbow wounds were open significantly longer in the cases than in the controls (48.7 days vs 24.2 days,P< .01). On multivariate logistic regression, the adjusted odds ratio was 1.08 (95% CI 1.04–1.12,P< .01). Time to elbow wound closure significantly impacts the risk of development of heterotopic ossification. Therefore, to minimize risk of HO formation, increased attention is warranted to optimize time to wound closure over joints. In addition, consideration of other soft tissue coverage options such as local flaps, including fascia or muscle flaps, may be warranted in cases of very deep elbow buns with high risk of skin graft failure.