Objective To compare the clinical efficacy of early surgical treatment versus delayed surgical treatment in patients with open hand injuries.Methods A retrospective analysis of 483 patients with open hand injuries admitted to Beijing Friendship Hospital,Capital Medical University from January 2019 to January 2022 was performed.Patients were divided into an early surgery group(time from injury to surgery＜6 h,n=251)and a delayed surgery group(time from injury to surgery 6-24 h,n=232)based on the timing of surgery.The degree of injury,inci-dence of wound infection,incidence of surgical revision were compared between two groups,and functional recovery assessed by the Patient-Ra-ted Wrist Evaluation(PRWE)were compared between the two groups.According to the degree of injury,the incidence of hand wound infection,surgical revision,and PRWE wrist joint self-assessment scale scores were compared between patients with simple and complex injuries.Results There was no statistically significant difference in the severity of injury between the early surgery group and the delayed surgery group(P＞0.05).There were 65 cases(13.5％)of hand wound infections occurred in both groups.In patients with simple injuries,the infection rates in the early surgery group and the delayed surgery group were 17.1％and 12.8％,respectively;in patients with complex injuries,the infection rates of the two groups were 14.3％and 10.3％,respectively.There was no statistically significant difference in the infection rates between the early surgery group and the delayed surgery group(P＞0.05).There were 95 cases(19.7％)underwent surgical revision in both groups.In patients with simple injuries,the rates of revision in the early surgery group and delayed surgery groups were 8.1％and 12.8％,respectively.In patients with complex injuries,the rates of revision in the two groups were 22.9％and 29.5％,respectively.There was no statistically significant differ-ence in the incidence of surgical revision between the early surgery group and the delayed surgery group(P＞0.05).In patients with simple inju-ries,the postoperative PRWE scores of the early surgery group and the delayed surgery group were(7.78±1.87)and(7.93±2.04)points,re-spectively;in patients with simple injuries,the postoperative PRWE scores of the two groups were(8.07±2.03)and(8.73±3.61)points,re-spectively.There was no statistically significant difference in the postoperative PRWE scores between the early surgery group and the delayed sur-gery group(P＞0.05).The incidence of revision in patients with complex injuries was 26.2％,which was significantly higher than that in pa-tients with simple injuries(10.2％),the PRWE score was(8.41±1.93)points,which was significantly higher than that in patients with simple injuries[(7.85±1.95)points],and the differences were statistically significant(P＜0.05).Conclusion Postponing surgery to 6-24 hours after open hand injuries does not heighten the likelihood of surgical infection or remake surgery,and shows no notable influence on the restoration of hand function.However,the complexity of the patient's injury structure and the duration of surgery have a significant impact on functional outcomes.
关键词
开放性手部损伤/延迟手术/感染率/翻修发生率/手部功能
Key words
Open hand injury/Delayed surgery/Infection rate/Reoperation rate/Hand function
维普
万方数据