在重大下肢截肢之后切割负压伤口治疗的有效性:一项随机对照试验
V V Vaddavalli1, B Girdhani1, A Savlania1
1Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Annals of the Royal College of Surgeons of England
|July 12, 2023
概括
切口负压伤口治疗 (iNPWT) 显著减少了手术部位感染,并加快了外围动脉疾病 (PAD) 患者下肢截肢后的假肢资格.
科学领域:
- 血管外科 血管外科
- 伤口愈合 治愈 伤口愈合
- 再生医学是一种再生医学.
背景情况:
- 周围动脉疾病 (PAD) 显著复杂化了下肢截肢的结果.
- 标准的无菌带带是管理截肢伤口愈合的常规方法.
- 切口负压伤口治疗 (iNPWT) 是一种新的方法,可以增强截肢后的伤口愈合.
研究的目的:
- 评估iNPWT与标准带带相比在治疗PAD患者主要下肢截肢伤口方面的疗效.
- 评估iNPWT对伤口相关并发症和假肢适用时间的影响.
主要方法:
- 一个前性,随机对照试验,涉及50名经历了主要下肢截肢的PAD患者.
- 患者被分配到iNPWT或标准无菌布包裹组.
- 主要结局包括手术部位感染 (SSI),伤口脱落,血清瘤/血瘤和需要修改截肢;次要结局是对假肢的适用时间.
主要成果:
- 在iNPWT组显示显著较低的SSI发病率 (12%对36%,p=0.047).
- 虽然其他并发症,如伤口脱光和血清/血瘤,在iNPWT治疗中呈现下降趋势,但这些差异在统计学上并不显著 (p>0.05).
- 在iNPWT组中观察到对假肢适用时间的显著减少 (5.12 ± 1.53周对比6.8 ± 1.95周,p=0.002).
结论:
- iNPWT是一种有效的治疗选择,可以减少由于PAD导致的下肢截肢的主要手术部位感染.
- iNPWT显著加快了假肢安置的时间,从而缩短了这些患者的整体康复期.
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