Morris G Stephen, Brueilly Kevin E, Hanzelka Heather
Anderson Cancer Center, Houston, TX 77030-4009, USA.
Ostomy Wound Manage. 2007 Jan;53(1):52-7.
Wounds and the accompanying loss of skin integrity often place a patient at increased risk for disability or death. Billions of dollars are spent each year to treat wounds and the effectiveness of these different treatments is highly variable. Following a 1997 publication describing a new treatment therapy that involved creating negative pressure over the wound, many publications have described the purported mechanism of action by which negative pressure may help wounds heal. Although this therapy appears effective, it remains unknown whether it is more effective than other wound closure techniques. In addition, although many uncontrolled, non-randomized studies describing the effectiveness of this therapy have been published, few prospective randomized trials have been conducted. Small sample sizes, variable outcome measures across studies, and significant methodological problems in the available randomized control trials further limit the conclusions that can be drawn regarding the relative effectiveness of vacuum-assisted wound closure. Analysis of these data provides weak evidence to suggest that negative pressure therapy is superior to saline gauze dressings in healing chronic wounds. Randomized controlled trials comparing healing, costs of care, patient pain, and quality-of-life outcomes of this treatment to non-gauze type dressings and other treatment modalities are needed.
伤口以及随之而来的皮肤完整性丧失常常使患者面临更高的残疾或死亡风险。每年花费数十亿美元用于治疗伤口，而这些不同治疗方法的效果差异很大。1997年发表了一篇描述一种新治疗方法的文章，该方法涉及在伤口上施加负压，此后许多文章都描述了负压可能有助于伤口愈合的所谓作用机制。尽管这种疗法似乎有效，但它是否比其他伤口闭合技术更有效仍不清楚。此外，尽管已经发表了许多描述这种疗法有效性的非对照、非随机研究，但进行的前瞻性随机试验却很少。样本量小、各研究中结果测量指标不同，以及现有随机对照试验中存在的重大方法学问题，进一步限制了关于负压辅助伤口闭合相对有效性所能得出的结论。对这些数据的分析提供了薄弱证据，表明负压疗法在愈合慢性伤口方面优于盐水纱布敷料。需要进行随机对照试验，比较这种治疗方法与非纱布类敷料及其他治疗方式在伤口愈合、护理成本、患者疼痛和生活质量结果方面的差异。
