负压伤口治疗,以减少CRS/HIPEC后的手术部位感染
Kylie J Nabata1, Sabrina Rai1, Darren Zhao1
1Department of Surgery, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada.
Annals of surgical oncology
|April 23, 2024
概括
负压伤口疗法 (NPWT) 可以减少在细胞还原性手术和高温腹腔内化疗 (HIPEC) 后的手术部位感染 (SSIs). 这项研究发现,使用NPWT与这些患者患上SSI风险较低有关.
科学领域:
- 手术瘤学手术瘤学
- 伤口管理 伤口管理
- 预防传染病 预防传染病
背景情况:
- 手术部位感染 (SSIs) 是皮层恶性瘤的细胞还原性手术 (CRS) 和高热性皮层内化疗 (HIPEC) 后的一个重要并发症.
- 负压伤疗法 (NPWT) 是缓解SSI的潜在干预措施,但在这个特定患者群体中证据有限.
研究的目的:
- 评估常规负压伤口疗法 (NPWT) 在降低手术部位感染 (SSI) 发生率的有效性,该疗法适用于接受细胞还原性手术 (CRS) 和高温腹腔内化学疗法 (HIPEC) 的患者.
主要方法:
- 采用了回顾性前后研究设计,比较使用标准手术包裹 (SSD) 治疗的患者和使用NPWT管理的患者之间的SSI率.
- 这项研究包括178名在2013年11月至2021年12月期间在单一的三级护理中心接受CRS/HIPEC治疗的患者.
- 多变量逻辑回归分析确定了与SSI发展相关的风险因素.
主要成果:
- SSI的发病率为SSD的11.4% (8/70) 和NPWT的5.6% (6/108),尽管这种差异最初没有统计学意义 (p = 0.16).
- 多变量分析显示,NPWT显著降低了SSI发展的风险 (OR 0.24,p = 0.037).
- 居住在距离医院50公里以上的地方被确定为SSI的重要危险因素 (OR2.03,p=0.026).
结论:
- 负压伤口疗法 (NPWT) 的常规应用似乎是一种有效的策略,可以降低手术部位感染 (SSI) 的风险,在接受细胞还原性手术 (CRS) 和高热性腹腔内化学疗法 (HIPEC) 的患者中.
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