关闭协议对腹壁重建中的伤病率的影响
William R Lorenz1, Ansley B Ricker1, Alexis M Holland1
1Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Surgical endoscopy
|December 6, 2024
概括
在腹壁重建 (AWR) 后,实施关闭协议 (CP) 显著减少了伤口并发症 (WC) 和伤口感染 (WI). 这种标准化的方法对于改善患者在AWR手术中的结果至关重要.
科学领域:
- 手术创新 在外科创新.
- 在腹壁重建的患者安全.
背景情况:
- 在腹壁重建 (AWR) 后的伤口并发症 (WC) 增加了成本,复发率和网状感染.
- 标准化手术关闭协议 (CP) 在其他外科领域已经显示出好处,但在AWR中仍未得到充分研究.
研究的目的:
- 评估一种新型的手术关闭协议 (CP) 对在接受以网状腹壁重建 (AWR) 的患者中减少伤口并发症 (WC) 的影响.
主要方法:
- 在第三级中心的潜在机构数据库中查询了用网格进行开放式AWR的患者.
- 该研究比较了2016年底实施CP之前和之后的伤口感染 (WI) 和WC率.
- 用贝叶斯结构化的时间序列分析来评估CP对WI和WC率的影响.
主要成果:
- 实行CP导致伤口感染 (WI) 率从14.5%降至2.6% (P<0.001).
- 在CP引入后,整体伤口并发症 (WC) 率从29.3%降至10.3% (P < 0.001).
- 观察到伤口细胞炎,伤口感染和网状感染率的具体减少,贝叶斯分析显示,WI减少了83%和WC减少了67%.
结论:
- 通过采用网状的开放腹壁重建 (AWR) 引入标准化的闭合协议 (CP),可显著降低伤口感染 (WI) 和伤口并发症 (WC) 率.
- 这些发现强烈支持在AWR程序中考虑和采用此CP,以提高患者的治疗结果并减少手术部位并发症.
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