负压伤口治疗在腹部开放手术后伤口裂开患者中的应用:单中心经验。

Journal of the Korean Surgical Society Pub Date : 2013-10-01 Epub Date: 2013-09-30 DOI:10.4174/jkss.2013.85.4.180
Ji Young Jang, Hongjin Shim, Yun Jin Lee, Seung Hwan Lee, Jae Gil Lee
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引用次数: 10

摘要

目的:自20世纪90年代以来,负压创面疗法(NPWT)已被用于治疗软组织缺损、烧伤创面和实现植皮固定。在腹部外科领域,NPWT在腹部开放性伤口需要临时缝合和复视手术的病例中的应用越来越多。在本研究中,作者分析了接受NPWT治疗术后伤口裂开的患者。方法:回顾性分析2009年11月至2012年5月行腹部手术患者的计算机记录。结果:入选患者总数为50例,其中30例(60%)接受了紧急手术。诊断为腹膜炎或腹腔脓肿24例(48%)、肠梗阻10例(20%)、肿瘤7例(14%)、肠系膜缺血3例(6%)、腹膜积血1例(2%)。NPWT平均应用于术后12.9±8.2天,平均NPWT持续时间为17.9天(2 ~ 96天)。11例(22%)创面闭合失败患者创面较其他39例(78%)更深、更复杂(90.9% vs. 38.5%, P = 0.005)。2例(4%)因伤口愈合延迟而出现并发症。结论:由于肉芽形成和缝合,大多数患者恢复良好。NPWT被认为是方便和安全的,但需要一项前瞻性的比较研究来证实NPWT在伤口破裂患者中的有效性。
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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Application of negative pressure wound therapy in patients with wound dehiscence after abdominal open surgery: a single center experience.

Purpose: Since the 1990's, negative pressure wound therapy (NPWT) has been used to treat soft tissue defects, burn wounds, and to achieve skin graft fixation. In the field of abdominal surgery, the application of NPWT is increasing in cases with an open abdominal wound requiring temporary wound closure and a second look operation. In the present study, the authors analyzed patients that underwent NPWT for postoperative wound dehiscence.

Methods: The computerized records of patients that had undergone an abdominal operation from November 2009 to May 2012 were retrospectively analyzed.

Results: The number of total enrolled patients was 50, and 30 patients (60%) underwent an emergency operation. Diagnoses were as follows: panperitonitis or intra-abdominal abscess (24 cases, 48%), intestinal obstruction (10 cases, 20%), cancer (7 cases, 14%), mesentery ischemia (3 cases, 6%), and hemoperitoneum (1 case, 2%). NPWT was applied at a mean of 12.9 ± 8.2 days after surgery and mean NPWT duration was 17.9 days (2 to 96 days). The 11 patients (22%) with unsuccessful wound closure had a deeper and more complex wound than the other 39 patients (78%) (90.9% vs. 38.5%, P = 0.005). There were two complication cases (4%) due to delayed wound healing.

Conclusion: Most patients recovered well due to granulation formation and suturing. NPWT was found to be convenient and safe, but a prospective comparative study is needed to confirm the usefulness of NPWT in patients whose wounds are dehisced.

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