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在受污染的腹中延迟与单阶段腹壁重建
Sara M Maskal1, Raha Al Marzooqi2, Ouen Mali2
1Center for Abdominal Core Health, Cleveland Clinic, 2049 E 100th St, Desk, A-100, Cleveland, OH, 44106, USA. Maskals2@ccf.org.
对于受污染的腹修复,延迟和单阶段腹壁重建 (AWR) 在伤口并发症和复发方面表现相似. 这表明,对于复杂的病例,这两种方法都是可行的.
科学领域:
- 手术创新 在外科创新.
- Hernia 修复技术 的修复技术
- 腹壁的重建 腹壁的重建
背景情况:
- 污染的腹修复带来了手术困境:单阶段修复或延迟重建.
- 外科医生必须权衡立即修复的风险与受污染领域分阶段方法的潜在好处.
研究的目的:
- 为了比较伤口并发症,长期的复发和生活质量.
- 在干净受污染和受污染的伤口中评估延迟与单阶段腹壁重建 (AWR).
主要方法:
- 对接受用回肌合成网 (2014-2023) 进行开放式AWR的成年患者的回顾性审查.
- 延迟AWR (最初没有网格的单独操作) 与单阶段AWR (同时放置的网格) 的比较.
- 分析的结果包括伤口发病率,重新手术和的复发率.
主要成果:
- 分析了63名延迟AWR和375名单阶段AWR患者,随访时间中位数为3年.
- 伤口脱皮和网状切除率在各组之间相似 (p > 0.05).
- 在伤口发病率,重新手术或的复发方面没有发现显著差异 (p > 0.05).
结论:
- 延迟和单阶段的AWR都是对带有清洁污染或受污染的伤口的腹腔的可行选择.
- 患者选择和手术策略可以根据个体病例的复杂性量身定制.
- 进一步的研究可能会探索长期生活质量差异.
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