Matthias Knobe1, Lukas D Iselin2, Bryan J M van de Wall2, Philipp Lichte3, Frank Hildebrand3, Frank J P Beeres2, Björn-Ch Link2, Boyko Gueorguiev4, Sven Nebelung5, Bergita Ganse6,7, Filippo Migliorini8, Kajetan Klos9, Reto Babst2, Pascal C Haefeli2. 1. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, 6000, Luzern 16, Switzerland. matthias.knobe@luks.ch. 2. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, 6000, Luzern 16, Switzerland. 3. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany. 4. AO Research Institute Davos, Davos, Switzerland. 5. Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany. 6. Werner Siemens Foundation Endowed Chair for Innovative Implant Development, Clinics and Institutes of Surgery, Saarland University, Homburg, Germany. 7. Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Homburg, Germany. 8. Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany. 9. Gelenkzentrum Rhein-Main, Hochheim am Main, Germany.
Abstract
PURPOSE: To assess which pre-operative parameters correlate with wound revisions after an extended lateral approach to the calcaneus. METHODS: Pre-operative laser-Doppler spectrophotometry was applied in patients undergoing open reduction and internal fixation. The number of wound revisions was recorded during pos-toperative follow-up. Spearman rho analysis was used to identify factors associated with wound revision and receiver operator characteristics curves were calculated for the identified factors. RESULTS: Thirty-four patients (29 men, 5 women; 37 calcanei) with a mean patient age of 43 ± 14 years were analyzed. The minimal oxygen saturation value at the five measurement locations as well as the minimal value for flow correlated negatively with wound revisions (p value = 0.025 and 0.038, respectively). The area under the curve for the pre-operative minimal value of oxygen saturation was 0.841 (95%CI 0.64-1.00, p = 0.028), indicating a good accuracy as a test to predict wound revision. CONCLUSION: A pre-operative oxygen saturation of at least 20.5% across five measurement points along the anticipated incision identified all patients not needing a wound revision (negative predictive value 100%). On the other hand, patients with at least one measurement below 20.5% were at risk for wound revision surgery (sensitivity 100%, specificity 48.5%). ClinicalTrials.gov NCT01264146.
PURPOSE: To assess which pre-operative parameters correlate with wound revisions after an extended lateral approach to the calcaneus. METHODS: Pre-operative laser-Doppler spectrophotometry was applied in patients undergoing open reduction and internal fixation. The number of wound revisions was recorded during pos-toperative follow-up. Spearman rho analysis was used to identify factors associated with wound revision and receiver operator characteristics curves were calculated for the identified factors. RESULTS: Thirty-four patients (29 men, 5 women; 37 calcanei) with a mean patient age of 43 ± 14 years were analyzed. The minimal oxygen saturation value at the five measurement locations as well as the minimal value for flow correlated negatively with wound revisions (p value = 0.025 and 0.038, respectively). The area under the curve for the pre-operative minimal value of oxygen saturation was 0.841 (95%CI 0.64-1.00, p = 0.028), indicating a good accuracy as a test to predict wound revision. CONCLUSION: A pre-operative oxygen saturation of at least 20.5% across five measurement points along the anticipated incision identified all patients not needing a wound revision (negative predictive value 100%). On the other hand, patients with at least one measurement below 20.5% were at risk for wound revision surgery (sensitivity 100%, specificity 48.5%). ClinicalTrials.gov NCT01264146.
Authors: Felix Marius Bläsius; Laura Elisabeth Stockem; Matthias Knobe; Hagen Andruszkow; Frank Hildebrand; Philipp Lichte Journal: Eur J Trauma Emerg Surg Date: 2022-01-06 Impact factor: 2.374