在下肢血管外科手术中使用Prevena VAC疗法管理切口伤口:一项比较研究
Kody Kasten1, Andrew Yang1, Lynn Shaffer1
1Vascular Surgery/General Surgery, Mount Carmel Health System, Columbus, OH, USA.
Vascular
|April 12, 2024
概括
与传统带相比,负压伤口治疗 (NPWT) 显著减少了血管外科手术患者的伤口并发症. 这种疗法对高风险患者特别有益,改善愈合并减少医院资源使用.
科学领域:
- 血管外科 血管外科
- 伤口愈合 治愈 伤口愈合
- 传染性疾病 传染性疾病
背景情况:
- 血管外科部位感染 (SSIs) 发生在5-10%的动脉干预和10-20%的下肢旁路移植中.
- 血管外科手术患者面临更高的术后伤口感染和并发症的风险.
- 研究了一种减少这些并发症的方法.
研究的目的:
- 为了比较切口负压伤口治疗 (NPWT) 和血管外科手术患者的常规带之间的伤口愈合并发症.
- 在2周的随访中评估完整伤口关闭的初级终点.
- 评估二次终点,包括感染率,需要伤口修复和伤口脱光.
主要方法:
- 一个前性队列研究与一个回顾性对照组进行了下内血管手术.
- 包括在2014年至2018年期间接受了下肢血管手术的患者,主要关闭距离沟的关节.
- 使用Prevena Wound VAC的实验组与使用常规带的对照组进行了比较.
主要成果:
- 总共有201名患者被研究 (64名Prevena,137名对照).
- 预防组在2周内显示出开放性伤口显著减少 (10.9%与33.6%,p = .0005).
- 在Prevena手臂中,整体并发症明显较低 (20.3%对52.6%,p < .0001).
结论:
- 在血管外科手术中,应强烈考虑负压伤疗法 (NPWT),主要用于血管外科手术中的闭合下内切口.
- 对于高风险患者 (如高BMI,吸烟者,糖尿病患者) 来说,NPWT特别有效,以预防感染.
- 这种方法可以减少抗生素的使用,急救诊所的访问,再入院和手术修订,从而降低医疗保健成本.
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