封闭切口负压疗法作为一种策略,以减少确定高风险患者的胸部伤口感染:一个多中心倾向匹配的研究
Rona Lee Suelo-Calanao1, Andrea D'Alessio2, Sandra Hutton2
1Castle Hill Hospital, Hull University Teaching Hospital, Hull, United Kingdom.
Interdisciplinary cardiovascular and thoracic surgery
|April 8, 2024
概括
封闭切口负压疗法 (ciNPT) 在高风险心脏手术患者中显著降低了胸部伤口感染. 这种疗法为改善复杂手术病例的结果提供了一种有希望的方法.
科学领域:
- 心胸外科手术 心胸外科手术
- 感染控制 感染控制
- 医疗器械 医疗器械
背景情况:
- 胸部伤口感染 (SWIs) 在心脏手术后具有显著的风险,特别是在多病患者中.
- 在高风险人群中,标准护理包裹可能无法充分预防SWI.
- 确定有效的干预措施来减少SWI发病率对于患者的治疗结果至关重要.
研究的目的:
- 评估术内闭切口负压疗法 (ciNPT) 在减少术后胸部伤口感染方面的疗效.
- 为了在高风险的心脏手术患者中比较ciNPT与标准护理包裹.
- 评估ciNPT对深部和表面骨伤口感染的影响.
主要方法:
- 这是一项回顾性研究,分析了来自英国3家医院的5,288名成人心脏手术患者的数据.
- 高风险患者被定义为具有两种或多种已知的SWI风险因素的患者.
- 使用倾向匹配来比较ciNPT组和标准护理组之间的结果,使用费舍尔的精确测试和未配对的t-test进行统计分析.
主要成果:
- 与对照组相比,ciNPT组的整体SWI (5.6%与15.5%相比),深度SWI (1.8%与4.0%相比) 和表面SWI (3.8%与11.4%) 显著减少.
- ciNPT组的患者在统计学上显著更高的平均逗留时间 (11.23天 vs 9.66天) 和更高的平均物流EuroSCORE.
- 在ciNPT组中,由于SWI导致重症监护室的再入院明显较低 (0.39%对2.08%).
结论:
- 术内封闭切口负压疗法 (ciNPT) 是一种有效的干预措施,用于减少高风险心脏手术患者的胸部伤口感染.
- ciNPT显示,在深部和表面的骨伤口感染中显著减少.
- 进一步调查可能是有必要的,以探索导致在ciNPT集团逗留时间增加的因素.
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