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目的 回顾性研究全膝关节置换 (total knee arthroplasty,TKA) 术后切口愈合不良的成因及临床治疗效果.方法 2011年1月至2014年1月,在我院行初次全膝关节表面置换患者共612例 (798膝);出现术后切口愈合不良的患者共24例 (28膝 );分析病因、性别、侧别、糖尿病及止血带使用时间等因素对术后切口愈合不良的影响,观察切口处理后的转归情况.结果 术后切口并发症的发生率为3.9％.其中术后7天内换药时发现切口愈合不良患者共13例 (16膝 ),保守处理后良好愈合.拆线后出现切口坏死、裂开、窦道形成共计11例 (12膝),有2例 (2膝) 行关节切开清创抗生素骨水泥填充物植入、二期膝关节翻修术,其余通过换药、清创缝合切口愈合.统计学分析研究发现类风湿性关节炎患者、糖尿病患者以及止血带使用时间较长的患者其发生切口愈合不良的可能性明显偏高,(P＜0.05 ) 差异有统计学意义.结论 类风湿性关节炎、糖尿病患者 TKA 术后切口并发症发生率较高;良好的术前准备、较短的止血带使用时间有利于降低切口并发症;切口并发症应早期明确诊断并积极治疗.“,”Objective To investigate the causes and the clinical effects of postoperative wound complications following total knee arthroplasty ( TKA ) retrospectively.Methods From January 2011 to January 2014,612 cases ( 798 knees ) underwent primary TKA.24 cases ( 28 knees ) were of postoperative wound complications.The factors of etiology,gender,side,diabetes and duration of tourniquet use were analyzed to determine the cause of postoperative wound complications.Results were analyzed.Results Postoperatively,24 cases ( 28 knees ) had wound complications and the incidence rate was 3.9％.Poor wound healing occurred in 13 cases ( 16 knees ) within one week during the dressing change postoperatively,disappearing after conservative treatment.Necrosis,disruption,sinus track formation appeared in 11 cases ( 12 knees ) after the removal of stitches.Two cases ( 2 knees ) had open debridement,antibiotic bone cement implant and two-stage revision.Other cases recovered after symptomatic regular treatment.Among those 24 cases,patients with rheumatoid arthritis,diabetes and longer tourniquet use had a higher incidence rate of wound complications than regularly treated patients,with statistical significance (P＜0.05 ).Conclusions Patients with rheumatoid arthritis and diabetes are more likely to have wound complications after TKA.With good preoperative preparation and short duration of tourniquet application,the incidence rate of complications may decrease.It is necessary to make early deifnitive diagnosis of postoperative wound complications and provide proactive treatment.