Abstract
There are many defined risk factors for wound healing. Comorbidities and their treatment are identified to be one of them. The aim of this study is to verify whether there are significant differences in wound healing between patients with and without systemic diseases, who underwent hallux valgus correction with Scarf osteotomy. A total of 155 consecutive patients were included into this prospective study. All of the patients underwent Scarf osteotomy for hallux valgus correction. In 60,6% of patients comorbidities were present, most often hypertension (57 patients, 36,8%), hypothyroidism (19 patients 12,3%) and diabetes (7 patients, 4,5%) occurred. Most of the patients were women (96,1%). During the study complication rate was noted. Patients underwent follow-up: 1,2, 3, 6 and 12 weeks and 6 months after the surgery. Preoperatively and during the last visit treatment results were assessed with AOFAS HMI scale. Scar assessment was performed by independent observer with VAS followed by patient scar assessment with VSS. In 30 patients complications were noted (19,4%). Surgical site infection was found in 6 patients (3,9%). In 13 patients (8,4%) partial wound dehiscence occurred, in 5 of them (3,2%) additional skin closure (Steri-Strips) was applied. Treatment results assessed with AOFAS HMI scale were good and very good in both healthy and comorbidity group, and the results improved significantly after surgical procedure. Scar assessment with VAS was on the average 1,5 pts. Average result in VSS was 2 pts. Results in both scales were rated as very good. No statistically significant differences were found in both healthy and comorbidity group in scar assessment. Based on the results of the study authors believe there are no significant differences between patients with and without comorbidities in aspects like: complication rate, surgery result and scar assessment as long as foot surgery is concerned.
Highlights
Hallux valgus is the most common foot deformity in adults with the frequency of 2–4% in population [1,2]
Total complications rate was 19,4% (30 patients in total, 17 with comorbidities and 13 without) (S6 and S7 Tables). 6 patients (3,9%) suffered from superficial infection (SSI—surgical site infection) (5 patient with chronic diseases and 1 without), that was treated with the course of oral empirical antibiotics (S8 Table)
Partial wound dehiscence occurred in 13 patients (8,4%, 5 patients with comorbidities and 8 without) (S9 Table)
Summary
Hallux valgus is the most common foot deformity in adults with the frequency of 2–4% in population [1,2]. Wound healing in foot surgery author [3,4,5]. The incidence of chronic diseases is increasing with age. Comorbidities, such as diabetes, rheumatoid arthritis and other rheumatic diseases, smoking or obesity, play important part in wound healing and treatment result. The increasing role of cosmetic effect should be outlined, especially as the deformation concerns mostly women
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