Trueman Paul, Flack Sarah, Loonstra Ate, Hauser Tino
York Health Economics Consortium, University of York, Market Square, Vanbrugh Way, York, UK.
Int Wound J. 2008 Jun;5(2):225-31. doi: 10.1111/j.1742-481X.2008.00472.x.
The aim of this study was to review the feasibility of using vacuum-assisted closure (V.A.C.) Therapy for the management of surgical and traumatic wounds in the home care settings in the Netherlands. De-identified patient data were collected from a health insurance database in the Netherlands. All patients with complete records, including indication, age, duration of therapy and defined treatment goal between January and November 2006 were included. Data from 338 patients were analysed. On average, wounds had been present for 2 months before start of V.A.C. Therapy. Overall, 74% of patients reached the pre-defined therapy goal (77% for dehisced wounds, 68% for abdominal wounds, 73% for traumatic wounds and 91% for sternal wounds) with approximately 1 month of V.A.C. Therapy. There was a negative association between the wound duration prior to V.A.C. Therapy and the treatment success rate (r = -0.162, P = 0.003). Wounds with shorter duration (<or=4 weeks) prior to initiation of V.A.C. Therapy achieved an 82% success rate compared with 33% for wounds present for >6 months prior to V.A.C. Therapy. V.A.C. Therapy is a feasible and effective treatment for surgical and traumatic wounds in home care patients with over 70% of patients treated in this sample achieving pre-defined treatment goals. The success rate of V.A.C. Therapy is negatively associated with the duration of the wound before V.A.C. Therapy is commenced.
本研究的目的是评估在荷兰居家护理环境中使用负压封闭引流（V.A.C.）疗法处理手术伤口和创伤伤口的可行性。从荷兰一个医疗保险数据库中收集了去识别化的患者数据。纳入了2006年1月至11月期间所有记录完整的患者，包括适应证、年龄、治疗持续时间和明确的治疗目标。对338例患者的数据进行了分析。平均而言，伤口在开始V.A.C.疗法前已存在2个月。总体而言，约1个月的V.A.C.疗法后，74%的患者达到了预先确定的治疗目标（切口裂开伤口为77%，腹部伤口为68%，创伤伤口为73%，胸骨伤口为91%）。V.A.C.疗法前伤口持续时间与治疗成功率呈负相关（r = -0.162，P = 0.003）。V.A.C.疗法开始前持续时间较短（≤4周）的伤口成功率为82%，而V.A.C.疗法开始前存在超过6个月的伤口成功率为33%。对于居家护理患者的手术伤口和创伤伤口，V.A.C.疗法是一种可行且有效的治疗方法，本样本中超过70%的患者实现了预先确定的治疗目标。V.A.C.疗法的成功率与开始V.A.C.疗法前伤口的持续时间呈负相关。
