Effects Of Serum Protein Levels On Postoperative Wound Healing In Patients After Total Knee Arthroplasty

ObjectiveThis study aims to collect guangdong hospital of total knee replacement(TKA)data of postoperative patient medical records were retrospectively study,in order to probe the nutrition of TKA perioperative is given priority to with serum albumin related index correlation with the condition of postoperative incision healing,clear TKA patients serum albumin levels influence on postoperative healing of incision,provide a reference for clinical prevention and poor healing of incision after TKA.MethodsThrough retrospective study,electronic medical records and relevant follow-up registration data of TKA patients in guangdong provincial hospital of traditional Chinese medicine from January to September 2018 were collected according to the established inclusion and exclusion indicators.The extracted information included:(2)nutrition index:total protein,albumin,hemoglobin,body mass index;(3)other indicators:erythrocyte sedimentation rate,hypersensitive c-reactive protein,white blood cell count;(4)surgical data:limb surgery,surgery time,intraoperative blood loss.(5)wound healing:fat liquefaction,percolation,skin temperature,postoperative VAS score,removal days.Relative risk,attributional risk,and percentage of attributional risk of poor wound healing in TKA patients were calculated according to the corresponding standards of albumin,prealbumin,hemoglobin,and body mass index.Meanwhile,univariate and multivariate logistic regression were used to analyze the influencing factors of poor wound healing.ResultsIn accordance with the established exclusion and inclusion criteria,140 patients with TKA were finally included in this study.The mean age of the subjects was 70.49±6.67 years,including 119 females(85%)and 21 males(15%).In laboratory nutrition indexes,the relative risk of poor wound healing in patients below the normal level was greater than 1 except for preoperative hemoglobin.The relative risk of poor wound healing in patients with lower than normal levels of preoperative albumin,postoperative D1 total protein,postoperative D1 albumin,postoperative D3 total protein and postoperative D3 albumin was greater than 2.The relative risk of poor wound healing in patients with lower than normal levels of postoperative D1 albumin,postoperative D3 total albumin,and postoperative D3 albumin were 3.6,3.2,and 4,respectively.Univariate analysis showed that there were statistically significant differences in age,preoperative albumin,preoperative CRP,preoperative Esr,postoperative D1 albumin,postoperative D1 Esr,postoperative D3 total protein,and postoperative D3 albumin between the two groups(P<0.05).In the multivariate logistic regression analysis,stepwise regression was used to screen the independent variables,and the results showed that postoperative D3 albumin level was an independent protective factor for poor wound healing(P<0.05).Conclusion1.When the total protein and albumin levels in the perioperative period of TKA patients are lower than normal,the incidence of poor wound healing will be significantly increased,and the relative risk of poor wound healing corresponding to preoperative albumin,postoperative D1 albumin,postoperative D3 total protein and postoperative D3 albumin is the highest,which should be paid attention to.2.Nutritional indexes:preoperative albumin,postoperative D1 albumin,postoperative D3 total albumin,and postoperative D3 albumin were associated with poor postoperative wound healing in TKA patients.3.Other related factors:age of patients is related to poor wound healing,and elderly patients should pay attention to the prevention of poor wound healing.Preoperative esr,preoperative CRP and postoperative D1 esr were associated with poor wound healing.4.Postoperative D3 albumin level is an independent protective factor for poor postoperative wound healing in elderly patients with TKA,and it should be clinically noted to promote the improvement of postoperative D3 albumin level.