预防手术部位感染的负压包裹:SUNRISE随机临床试验
, Kristy Atherton1, James Brown2
1The University of Newcastle, Sydney, Australia.
JAMA
|January 27, 2025
概括
切割负压伤口治疗 (iNPWT) 没有减少手术部位感染 (SSI) 在接受紧急腹腔切除的患者. 这项研究发现iNPWT和标准带之间的SSI率没有显著差异.
科学领域:
- 外科创新
- 伤口管理
- 感染控制
背景情况:
- 接受非计划腹部手术的患者面临更高的手术部位感染 (SSI) 风险.
- 切割负压伤口治疗 (iNPWT) 在缓解高危人群中SSI的有效性仍然不确定.
研究的目的:
- 评估iNPWT在减轻SSI发生率的成年患者的有效性,这些成年患者接受了急诊腹腔切除,并关闭了主要皮肤.
主要方法:
- 一项第三期随机临床试验 (SUNRISE) 涉及英国和澳大利亚34家医院的840名成年患者.
- 参与者被分为1:1接受iNPWT或外科医生选择的在手术室应用的标准伤口带.
- 主要结局是30天内发生的SSI,由面具评估人员使用CDC标准进行评估.
主要成果:
- 在iNPWT组 (28. 4%) 和外科医生偏好组 (27. 4%) 之间没有观察到SSI率的显著差异 (RR,1. 03;P=78).
- 这些发现在预先指定的子组和敏感性分析中保持一致.
- 七个次要结果中的六个,包括住院和再入院率,也没有显示两组之间的显著差异.
结论:
- 在紧急腹腔切除术后,在闭合的外科创伤上常规使用iNPWT似乎没有比标准带更有效地预防手术部位感染.
- 可能需要进一步的研究来确定iNPWT可能有益的特定患者子组或条件.
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