ABSTRACT
Objective To compare the efficacy between three-layer suture and Allg(o)wer-Donati suture on wound healing.Methods From September 2016 to June 2018,patients with Sanders type Ⅲ calcaneal fracture were randomly divided into two groups:three-layer close suture group (26 cases,18 males and 8 females,aged 19-48 years,with an average age of 33.69±8.84 years) and Allg(o)wer-Donati group (26 cases,19 males and 7 females,aged 19-49 years,with an average age of 32.38±8.45 years).The traditional L-shaped incision was used in all patients.The inflammatory reaction area of incision,skin temperature change at the corner of L-shaped incision line and the healing grade of incision were compared between the two groups.Results 52 patients were followed up for 6 months.At 2 weeks after operation,the inflammatory reaction area of incision skin in the three-layer close skin suture group (26.46±9.37 mm2) was smaller than that in Allg(o)wer-Donati suture group (33.16±9.33 mm2).There was a significant difference between the two groups (t=2.584,P=0.013).There was no difference in skin temperature at the comer of Lshaped incision between the two groups before and on the first day after operation.However,the incision skin temperature of the three-layer close suture group on the 2nd and 3rd day after operation [(36.47±0.33)℃ and (36.54±0.22)℃] was higher than that of Allg(o)wer-Donati group [(36.20±0.42)℃ and (36.22±0.43)℃].The difference was statistically significant (t=2.61,P=0.01;t=3.48,P=0.001).There were 25 cases of Class A healing and 1 case of Class B healing in three-layer close suture group,with Class A healing rate of 96.15％ (25/26).In Allg(o)wer-Donati group,there were 22 cases of Class A healing,1 case of Class B healing,and 3 cases of Class C healing,with Class A healing rate of 84.62％ (22/26).Among all grade B healing incisions,1 case had a small amount of local hemorrhagic exudation in the three-layer close suture group,while 1 case had a black necrosis at the edge of the incision,3 cases had a purulent incision and exposed steel plate in the Allg(o)wer-Donati group.Conclusion In the treatment of L-shaped incision of calcaneal fracture,three-layer close suture is a better method than Allg(o)wer-Donati suture because of smaller inflammatory reaction area of incision,higher skin temperature change at the comer of L-shaped incision on the 2nd and 3rd day after operation,higher rate of first-degree healing of incision and slighter incision complications.