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고관절 전치환술 시행 환자에서 수술전후 영양상태와 상처치유 지연과의 관계
서근택 ( Kuen Tak Suh ),김승욱 ( Seung Wook Kim ),유총일 ( Chong Il Yoo ) 대한고관절학회 1995 Hip and Pelvis Vol.7 No.2
In total hip arthroplasty, there is alarmingly high frequency of the subclinical perioperative malnutrition which is easily neglected. Nutritional status has a close relationship with the normal wound healing mechanism. So it is important to determine the most sensitive index for detecting perioperative nutritional depletion. We performed study about the relation between the perioperative nutritional status and the delayed wound healing after total hip arthroplasty. For this study, we reviewed 74 cases of total hip arthroplasties and analysed various indices of nutritional status. Following results were obtained: 1. Delayed wound healing complicated 18 of the 74(24.3%) total hip arthmplasties. 2. There was significant trend for patients with delayed wound healing to be older than those with normal wound healing(67.3 years versus 54.7 years; p<0.05). Delayed wound healing group also had tendency to be more obese than normal healing group(p<0.05). 3. Statistically significant perioperative nutritional indices which were related to the delayed wound healing were the serum albumin level and the serum transferrin level(P<0.05). 4. Moderate to severe albumin depletion were observed in 13 cases preoperatively and all of them had delayed wound healing. Preoperatively, moderate to severe transferrin depletion were observed in 23% of normal healing group and 83% of delayed wound healing group. 5. Postoperatively, 90% and 89% of all 74 cases were found to have at least moderate serum albumin and transferrin depletion respectively. 6. The patients with delayed wound healing had complete wound healing until 24 days after surgery except three patients complicated wound infection.