Flap Viability after Direct Immediate Application of Negative Pressure Wound Therapy on Free Flaps: A Systematic Review and Pooled Analysis of Reported Outcomes

Jude L. Opoku-Agyeman, D. Matera, Jamee E. Simone, A. Behnam
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引用次数: 8

Abstract

Abstract Background The use of negative pressure wound therapy (NPWT) devices has gained wide acceptance in the management of wounds. There have been a few reported cases of its use immediately after free tissue transfer. This is the first systematic review and pooled analysis on the immediate use of NPWT for free flaps with emphasis on the rate of free flap loss. Methods The authors performed a systematic review that focused on the rate of total free flap loss after immediate application of NPWT. EMBASE, Cochrane Library, Ovid Medicine, MEDLINE, Google Scholar, and PubMed databases were searched from 1997 to April of 2019. Peer-reviewed articles published in the English language were included. Results Ten articles were included in the review, yielding 211 free flap procedures. All studies were retrospective cohort studies except for two that were prospective studies and one that was a case series. The overall complete flap failure rate was n = 7 (3.3%). The most commonly reconstructed area was the lower extremity (n = 158 [74.9%]) followed by head and neck (n = 42 [19.9%]) and upper extremity (n = 11 [5.2%]). The vacuum pressure ranged from 75 to 125 mm/Hg. The time of application of the NPWT ranged from 5 to 7 days. The etiologies of wound defects were from trauma (n = 82 [63.6%]), tumor extirpation (n = 43 [33.3%]), and infection and burn (n = 4 [3.1%]). Conclusion The immediate application of NPWT on free flaps does not seem to be associated with an increased risk of flap failure.
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直接应用负压创面治疗游离皮瓣后皮瓣存活:系统回顾和汇总分析报道结果
摘要背景 负压伤口治疗(NPWT)装置的使用在伤口管理中已获得广泛接受。据报道,在游离组织移植后立即使用它的案例很少。这是第一次对立即使用NPWT进行游离皮瓣的系统综述和汇总分析,重点是游离皮瓣的损失率。方法 作者进行了一项系统综述,重点关注立即应用NPWT后总游离皮瓣损失率。从1997年到2019年4月,检索了EMBASE、Cochrane图书馆、Ovid Medicine、MEDLINE、Google Scholar和PubMed数据库。包括以英文发表的同行评议文章。后果 该综述共收录了10篇文章,产生了211个游离皮瓣手术。除了两项前瞻性研究和一项病例系列研究外,所有研究都是回顾性队列研究。整个皮瓣的失败率为n = 7(3.3%)。最常见的重建区域是下肢(n = 158[74.9%]),然后是头部和颈部(n = 42[19.9%])和上肢(n = 11[5.2%])。真空压力范围为75至125 毫米/汞柱。施用NPWT的时间为5至7天。伤口缺损的病因为外伤(n = 82例[63.6%]),肿瘤摘除(n = 43例[33.3%])、感染和烧伤(n = 4[3.1%])。结论 在游离皮瓣上立即应用NPWT似乎与皮瓣失效风险的增加无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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审稿时长
14 weeks
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