负压创面治疗在犬开放性创面治疗中的全身效果评价

VCOT Open Pub Date : 2019-07-01 DOI:10.1055/s-0039-1693007
R. Albert, S. Reese, M. Nolff, A. Meyer-Lindenberg
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引用次数: 1

摘要

摘要目的探讨负压创伤治疗(NPWT)对犬复杂创伤的全身性影响。材料和方法将接受开放性伤口治疗的狗随机分为两组:NPWT (n = 11)或聚氨酯泡沫敷料(n = 11)。从治疗开始(第0天)到第5天和第10天,每天记录直肠温度、心率以及红细胞压积、血小板、白细胞计数、带中性粒细胞、c反应蛋白(CrP)、总蛋白和白蛋白。评估了治疗对全身参数的影响,以及个体参数对伤口成功愈合的预后作用。结果NPWT组全身总蛋白水平明显下降。这种差异不显著。与成功治疗的患者相比,未成功治疗的患者在第4、5和10天的初始白细胞和血小板计数较低,CrP值显着升高(p < 0.05)。受试者工作特性分析显示,第4天最佳临界值为70.2 mg/L(灵敏度80;特异性为85.7)。结论与对照组相比,npwt治疗组可能存在蛋白损失增加,但不影响白蛋白水平,否则未见全身性影响。检测严重并发症(未完成缝合)的敏感性和特异性最佳参数是第4天的CrP。
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Evaluation of Systemic Effects of Negative Pressure Wound Therapy in Open Wound Treatment in Dogs
Abstract Objectives The aim of this study was to evaluate the systemic effect of negative pressure wound therapy (NPWT) on the treatment of complicated wounds in dogs. Materials and Methods Dogs undergoing open wound treatment were randomly assigned to one of two groups: NPWT (n = 11) or polyurethane foam dressing (n = 11). Rectal temperature, heart rate as well as haematocrit, thrombocytes, leucocyte count, band neutrophils, C-reactive protein (CrP), total protein and albumin were recorded daily from the beginning of therapy (day 0) until day 5, as well as on day 10. The effect of treatment on systemic parameters was evaluated as well as the prognostic power of the individual parameters with regard to successful wound closure. Results A more profound systemic decrease was found in total protein under NPWT. This difference was non-significant. Patients with non-successful closure displayed a non-significant trend towards lower initial leukocyte and thrombocyte counts and significantly higher CrP values on days 4, 5 and 10 (p < 0.05) compared with successfully treated patients. Receiver operating characteristic analysis revealed an optimal cutoff value of 70.2 mg/L at day 4 (sensitivity 80; specificity of 85.7). Conclusion There might be an increased loss of protein in NPWT-treated patients, which does not affect albumin levels, otherwise no systemic effects were detected compared with the control treatment. The parameter with the best sensitivity and specificity to detect serious complications (no wound closure achieved) was CrP at day 4.
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