负压服装与常规的被动服装在柱状手术:一个随机对照试验
Nicholas Ensor1, Sarah Martin2, Annette Chang1
1Department of Paediatric Surgery, Urology & Surgical Simulation, Monash Children's Hospital, Melbourne, Australia.
The Journal of surgical research
|October 11, 2024
概括
负压伤疗法 (NPWT) 在柱状鼻疾病 (PSD) 切除中没有降低外科创伤脱离率. 这项研究表明,NPWT不是PSD手术伤口的常规预防措施.
科学领域:
- 手术创新和伤口愈合研究.
- 临床试验方法在外科手术的结果.
背景情况:
- 柱状鼻疾病 (PSD) 手术的并发症率很高,包括手术伤口脱光 (SWD),高达44%.
- 负压伤疗法 (NPWT) 是一种潜在的干预措施,以减轻高风险手术伤口中的SWD.
研究的目的:
- 评估NPWT与传统的被动 (CP) 敷料相比,在PSD切除后减少SWD率的有效性.
- 评估NPWT对患者生活质量和PSD手术后恢复正常活动的影响.
主要方法:
- 一个前性,交叉随机受控试验,涉及50名患有PSD的患者 (12-40岁).
- 参与者被随机分配,接受NPWT (SNAP) 或CP (Primapore或Opsite) 的敷料.
- 随访包括定期的伤口评估和为期2个月的术后在线调查,以了解生活质量的结果.
主要成果:
- 整体死亡率为42% (21/50),NPWT组为48%,CP组为36% (P=0.6).
- 两组之间没有观察到深度SWD率,伤口愈合的持续时间,或返回学校/工作的时间,正常坐着或身体活动的显著差异.
- 只有在NPWT组中,SWD与切除尺寸的增加有关 (P=0.03).
结论:
- 在非中线初级关闭的PSD切除术中,NPWT并没有在手术伤口消化或生活质量方面显示出改善的结果.
- 这些发现不支持NPWT作为这些特定手术程序的预防措施的常规使用.
- 进一步的研究可能是有必要的,但目前的证据表明,这种患者群体的益处有限.
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