负压伤口治疗和先进干预措施在预防手术部位感染方面的有效性:系统性审查
Muaz Hassan1, Mohamed Eltayeb Abdelrahman Naiem2,3, Moustafa U Abdelradi4
1General Surgery, Alnao Teaching Hospital, Khartoum, SDN.
Cureus
|December 3, 2025
概括
先进的伤口疗法,如负压伤口疗法 (NPWT),在预防手术部位感染 (SSI) 方面表现出不同的成功. 它们的有效性取决于特定的外科手术程序,而不是普遍的应用.
科学领域:
- 感染控制 感染控制
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 手术部位感染 (SSI) 是患者发病率和医疗保健费用增加的重要原因之一.
- 先进的伤口护理,包括负压伤口治疗 (NPWT),越来越多地用于降低SSI风险.
- 现有证据表明,这些先进的干预措施在不同手术过程中的有效性是不一致的.
研究的目的:
- 系统地审查随机对照试验 (RCT),评估NPWT和先进伤口包裹在预防SSI方面的有效性.
- 将这些干预措施与各种手术环境中的常规带或标准护理进行比较.
主要方法:
- 对五个主要的电子数据库和临床试验注册表进行了全面的搜索.
- 包括的研究是发布到2025年的随机对照试验 (RCT).
- 独立审稿人使用柯克兰偏差风险2工具进行了研究选择,数据提取和偏差风险评估.
主要成果:
- 分析了8个RCT,涵盖了诸如紧急腹腔切除术,血管手术,剖腹产和骨科创伤等手术.
- 在开放的 inguinal 血管手术中,NPWT 证明了显著的 SSI 减少;在剖腹产时,DACC 浸的敷料是有效的.
- 在紧急腹腔切除术后切口NPWT没有观察到SSI益处,骨科创伤的结果是混合的.
结论:
- 在SSI预防方面,NPWT和先进的伤口干预措施的有效性高度取决于具体情况,根据手术程序和患者群体而异.
- 建议基于在特定环境中证明的益处选择性应用,而不是常规使用.
- 未来的研究应该确定预测因素,以指导这些先进疗法的个性化和成本效益的实施.
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