Armstrong David G, Attinger Christopher E, Boulton Andrew J M, Frykberg Robert G, Kirsner Robert S, Lavery Lawrence A, Mills Joseph L
Department of Surgery, Southern Arizona Veterans Affairs Medical Center, Tucson, USA.
Ostomy Wound Manage. 2004 Apr;50(4B Suppl):3S-27S.
The purpose of these guidelines is to the summarize consensus of a multidisciplinary expert advisory panel convened to determine appropriate use of negative pressure wound therapy (NPWT), also known as Vacuum-Assisted Closure or V.A.C. Therapy, in the treatment of diabetic foot wounds. The Tucson Expert Consensus Conference (TECC) on V.A.C. Therapy was convened in an effort to guide the direction for future research either to confirm or refute current consensus while providing practical guidance to the clinician currently treating diabetic foot wounds. The consensus committee discussed and commented on the following ten key questions regarding NPWT: 1) How long should NPWT be used in the treatment of a diabetic foot wound? 2) Should NPWT be applied to a wound that has not been debrided? 3) How should the patient using NPWT be evaluated on an outpatient basis? 4) When should NPWT be applied following lower-extremity bypass? 5) When should NPWT be applied after incision and drainage of infection? 6) How should NPWT be used in patients with osteomyelitis? 7) How should nonadherence (i.e., noncompliance) be defined in the patient on NPWT? When should NPWT be discontinued in this population? 8) How should NPWT be used in combination with other modalities? 9) Should small, superficial, noninfected wounds be considered for NPWT? 10) How should we define success in future studies of NPWT?
这些指南的目的是总结一个多学科专家咨询小组的共识，该小组旨在确定负压伤口治疗（NPWT），也称为真空辅助闭合或V.A.C.治疗，在糖尿病足伤口治疗中的适当应用。关于V.A.C.治疗的图森专家共识会议（TECC）召开，旨在为未来研究指明方向，以证实或反驳当前的共识，同时为目前治疗糖尿病足伤口的临床医生提供实用指导。共识委员会就以下关于NPWT的十个关键问题进行了讨论并发表了意见：1）NPWT治疗糖尿病足伤口应使用多长时间？2）NPWT是否应应用于未清创的伤口？3）如何对使用NPWT的患者进行门诊评估？4）下肢旁路手术后何时应应用NPWT？5）感染切开引流后何时应应用NPWT？6）NPWT在骨髓炎患者中应如何使用？7）如何定义使用NPWT患者的不依从（即不遵医嘱）？在这一人群中何时应停止使用NPWT？8）NPWT应如何与其他方式联合使用？9）小的、表浅的、未感染的伤口是否应考虑使用NPWT？10）在未来NPWT的研究中我们应如何定义成功？
