Philbeck T E, Whittington K T, Millsap M H, Briones R B, Wight D G, Schroeder W J
Kinetic Concepts, Inc., Medical Department, San Antonio, TX 78265-9508, USA.
Ostomy Wound Manage. 1999 Nov;45(11):41-50.
Pressure ulcers, a devastating and costly healthcare problem, often occur in home healthcare settings. We sought to determine if these and other chronic wounds treated at home with negative pressure wound therapy close faster and reduce treatment costs compared to conventional therapies. Records for 1,032 Medicare home healthcare patients with 1,170 wounds that failed to respond to previous interventions--and were subsequently treated with negative pressure wound therapy--were reviewed. Reductions in wound area and volume were compared to rates reported by Ferrell in 1993, and costs were analyzed. Ferrell reported trochanteric and trunk pressure ulcers averaging 4.3 cm2, treated with a low-air-loss surface and saline-soaked gauze closed at an average of 0.090 cm2 per day. For comparison to Ferrell's outcomes, we analyzed our Stage III and IV trochanteric and trunk wounds treated with low-air-loss and negative pressure wound therapy. Ours averaged 22.2 cm2 in area and closed at an average of 0.23 cm2 per day. The average 22.2 cm2 wound in our study, treated as described by Ferrell, would take 247 days to heal and cost $23,465. Using negative pressure wound therapy, the wound would heal in 97 days and cost $14,546. The study concluded that negative pressure wound therapy is an efficacious and economical treatment modality for a variety of chronic wounds.
压疮是一个极具破坏性且成本高昂的医疗保健问题，在家居医疗环境中经常出现。我们试图确定与传统疗法相比，在家中接受负压伤口治疗的这些伤口以及其他慢性伤口是否愈合得更快且治疗成本更低。我们回顾了1032名医疗保险家居医疗患者的记录，这些患者有1170处伤口，对先前的干预措施没有反应，随后接受了负压伤口治疗。将伤口面积和体积的减少情况与1993年费雷尔报告的比率进行比较，并对成本进行了分析。费雷尔报告称，转子和躯干压疮平均面积为4.3平方厘米，采用低气损表面和盐水浸湿纱布治疗，平均每天愈合0.090平方厘米。为了与费雷尔的结果进行比较，我们分析了采用低气损和负压伤口治疗的III期和IV期转子及躯干伤口。我们的伤口平均面积为22.2平方厘米，平均每天愈合0.23平方厘米。按照费雷尔描述的方法治疗，我们研究中平均面积为22.2平方厘米的伤口需要247天才能愈合，成本为23465美元。使用负压伤口治疗，伤口将在97天内愈合，成本为14546美元。该研究得出结论，负压伤口治疗是治疗各种慢性伤口的一种有效且经济的治疗方式。
