Effects of preoperative external application of Sihuang powder on soft tissue swelling and postoperative incision-related adverse events in patients with closed calcaneal fractures

WU Leilei; ZHAO Biyun; ZHANG Donping

doi:10.3969/j.issn.1002-266X.2025.06.018

Abstract：Objective To observe the effects of preoperative external application of Sihuang powder on soft tissue swelling and postoperative incision-related adverse events in closed calcaneal fracture patients.Methods Ninety-four patients with closed calcaneal fractures scheduled for surgical treatment were enrolled and randomly divided into the obser-vation group(n=49)and control group(n=45)using a random number table.Patients in the control group received con-ventional physical anti-swelling interventions preoperatively,including immobilization and elevation of the affected limb,ice application to the injured area,and intravenous mannitol infusion.Patients in the observation group were additionally treated with external application of Sihuang powder.Both groups underwent anti-swelling therapy for 3 days prior to sur-gery,followed by plate internal fixation via either a lateral L-shaped calcaneal incision or a tarsal sinus approach.The an-kle circumference,soft tissue swelling severity,time to reappearance of skin wrinkles,and incidence of postoperative inci-sion-related adverse events were compared between the two groups before and after anti-swelling therapy.Results In the observation group,ankle circumferences before and after swelling treatment were(37.09±1.89)cm and(33.86±2.24)cm,respectively.In the control group,the ankle circumferences were(36.65±1.79)cm and(34.80±1.62)cm,re-spectively.Compared with pre-treatment values,ankle circumferences decreased significantly in both groups after swelling treatment,with a more significant reduction observed in the observation group(both P<0.05).In the observation group,the degrees of soft tissue swelling were mild in 2 cases(4.1%),moderate in 43 cases(87.8%),severe in 4 cases(8.2%)before treatment,and mild in 41 cases(83.7%),moderate in 8 cases(16.3%),and 0 case after treatment.In the control group,the degrees of soft tissue swelling were mild in 2 cases(4.4%),moderate in 40 cases(88.9%),severe in 3 cases(6.7%)before treatment,and mild in 29 cases(64.4%),moderate in 16 cases(35.6%),and 0 case after treatment.Compared with pre-treatment status,soft tissue swelling significantly improved in both groups after treatment,with significant improvement observed in the observation group(both P<0.05).The observation group demonstrated signif-icantly shorter time to reappearance of skin texture and lower incidence of postoperative incision-related adverse events than the control group(both P<0.05).Conclusion Topical application of Sihuang powder helps alleviate preoperative soft tissue swelling in patients with closed calcaneal fractures and reduce the incidence of postoperative incision-related ad-verse events.