比较负压伤口疗法和渐近伤口疗法对感染性切口的治疗效果。

Yener Yoğun, Uğur Bezirgan, Mehmet Batu Ertan, Merve Dursun Savran, Peri Kindan, Mahmut Kalem, Mehmet Armangil
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摘要

负压伤口疗法(NPWT)和伤口逐步逼近术(GWA)是治疗筋膜切开术伤口的有效而可靠的方法。然而,这两种方法治疗感染性伤口的效果仍不明确。我们的研究旨在比较这两种治疗四肢感染性筋膜切开术伤口的延迟初级闭合方法。研究对象包括在 2023 年以卡赫拉曼马拉什为中心的地震中遭受挤压伤后接受四肢筋膜切开手术的患者,以及在随访期间因开放性伤口感染而转诊的患者。在本诊所完成伤口闭合过程的患者分为两组:NPWT 组和 GWA 组。通过回顾性收集的数据,比较了两组患者的人口统计学特征、伤口闭合时间、手术次数、植皮需求和并发症。此外,还对实验室参数进行了检查。13 名患者(21 处伤口)接受了 NPWT 治疗,14 名患者(22 处伤口)接受了 GWA 治疗。NPWT 组的平均年龄为(32.85 ± 18.37)岁,而 GWA 组的平均年龄为(25.21 ± 16.31)岁。NPWT 组和 GWA 组的手术次数分别为 5.38 ± 2.11 和 4.23 ± 1.27,差异有统计学意义(P = 0.040)。NPWT 组和 GWA 组的平均伤口闭合时间(P = .0210)(分别为 11.00 ± 4.86 天和 8.27 ± 2.41 天)也有显著差异。NPWT 组和 GWA 组分别有 5 名和 2 名患者进行了植皮手术。两组在植皮要求和并发症发生率方面无明显差异。NPWT 和 GWA 是关闭感染性筋膜切开术伤口的有效而可靠的方法。与使用 NPWT 相比,使用 GWA 可以在更短的时间内闭合这些伤口,手术次数也更少。
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Comparison of Negative-Pressure Wound Therapy and Gradual Wound Approximation Treatments for Infected Fasciotomy Wounds.

Negative-pressure wound therapy (NPWT) and gradual wound approximation (GWA) are effective and reliable methods of treating fasciotomy wounds. However, the effectiveness of these 2 methods in treating infected wounds remains unclear. The aim of our study was to compare these 2 delayed primary closure methods of treating infected fasciotomy wounds on the limbs. Patients who underwent fasciotomy surgery on the extremities after sustaining crushing injuries in the 2023 Kahramanmaraş-centered earthquakes and who were referred owing to infected open wounds during follow-up were included in the study. Patients who completed the wound closure process at our clinic were divided into 2 groups: the NPWT and GWA groups. Using retrospectively collected data, the groups were compared in terms of demographic characteristics, time until wound closure, number of surgeries, skin graft requirements, and complications. Laboratory parameters were also examined. Thirteen patients, (with 21 wounds) who underwent NPWT and 14 (with 22 wounds) who underwent GWA, were examined. The average age of the NPWT group was 32.85 ± 18.37 years, whereas that of the GWA group was 25.21 ± 16.31 years. The number of surgeries in the NPWT and GWA groups were 5.38 ± 2.11 and 4.23 ± 1.27, respectively, and the difference was statistically significant (P = .040). The average wound closure times of the NPWT and GWA groups (P = .0210) (11.00 ± 4.86 days and 8.27 ± 2.41 days, respectively) also differed significantly. Skin grafting was performed in 5 patients in the NPWT group and 2 in the GWA group. There were no significant differences between the 2 groups in terms of skin graft requirements or complication rates. NPWT and GWA are effective and reliable methods of closing infected fasciotomy wounds. Closure of these wounds can be achieved in a shorter time and with fewer surgeries using GWA than using NPWT.

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