预防性负压伤口治疗降低了表面手术部位感染的风险紧急手术患者:多中心随机化前性临床试验的结果
András Herczeg1, Attila Szijártó1, András Fülöp1
1Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.
International wound journal
|July 3, 2025
概括
预防性真空疗法,或封闭切口负压伤口疗法 (ciNPWT),在接受腹腔切口手术的普通手术患者中显著减少了手术部位感染. 这种方法为预防手术后感染提供了一个有希望的策略.
科学领域:
- 手术创新 在外科创新.
- 预防感染 预防感染
- 伤口管理 伤口管理
背景情况:
- 手术部位感染 (SSIs) 仍然是一个重要的术后并发症,尽管现代无菌技术.
- 虽然负压伤疗法 (NPWT) 已用于慢性伤口,但其在预防SSI方面的作用需要进一步的高水平证据.
- 封闭切口负压伤口治疗 (ciNPWT) 是NPWT在外科切口的特定应用.
研究的目的:
- 评估预防性封闭切口真空疗法 (ciNPWT) 在紧急腹腔切口术后减少手术部位感染 (SSI) 的有效性.
- 为了比较用ciNPWT治疗的患者和接受常规伤口包裹的患者之间的SSI率.
主要方法:
- 一个多中心,前性,随机试验,涉及90名接受紧急腹腔切除术的整体外科患者.
- 患者被随机分为两组:治疗组 (45名患者) 接受了为期5天的预防性ciNPWT疗程,对照组 (45名患者) 接受了标准的无菌带包裹.
- 手术部位感染率,包括表面和深部感染,是主要的结果指标.
主要成果:
- 与对照组 (44.4%) 相比,ciNPWT组的整体SSI率显著较低 (22.2%) (p=0.025).
- 在ciNPWT组 (40%的SSI) 与对照组 (20%的SSI) 相比,表面SSI显著减少 (p=0.038).
- 在两组之间深度SSI的比率没有观察到统计学上显著的差异 (4.4%对4.4%,p=1.0).
结论:
- 对封闭的手术切口进行负压伤口治疗 (NPWT) 的预防性应用可以有效地减少手术部位感染的总体发病率.
- ciNPWT显示出作为常规伤口管理的辅助来预防SSI,特别是表面性伤口的承诺.
- 进一步的研究可能会探索优化ciNPWT协议以解决深度SSI预防.
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