Sumpio Bauer E, Allie David E, Horvath Keith A, Marston William A, Meites Herbert L, Mills Joseph L R, Orgill Dennis P, Salazar Jorge D, Song David H, Toursarkissian Boulos
Department of Surgery, Yale University School of Medicine, New Haven, CT 06520-8062, USA.
Vascular. 2008 Jul-Aug;16(4):194-200. doi: 10.2310/6670.2008.00041.
Wound complications involving large subcutaneous vessels can cause significant challenges for surgeons. Negative pressure wound therapy (NPWT) has been increasingly used for treating complex wounds in vascular surgery, including groin infections, either as a bridge to surgical closure or as a primary wound treatment modality. Although a growing body of evidence exists for managing various problematic wounds, such as diabetic foot ulcers and open abdominal wounds, the role of NPWT in wounds involving large blood vessels or wounds complicating infected vascular grafts has not been well defined. A multidisciplinary advisory panel reviewed the literature relevant to wounds related to vascular surgical procedures and complications, focusing on large subcutaneous or infected vascular conduits. The results supported by the literature and the clinical practice of the consensus panel suggested that NPWT can be a useful adjunct to the management of vascular groin infections and dehiscences but must be used with caution.
涉及大皮下血管的伤口并发症会给外科医生带来重大挑战。负压伤口治疗(NPWT)已越来越多地用于治疗血管外科的复杂伤口,包括腹股沟感染,既作为手术闭合的桥梁,也作为主要的伤口治疗方式。尽管有越来越多的证据表明NPWT可用于处理各种问题伤口,如糖尿病足溃疡和开放性腹部伤口,但NPWT在涉及大血管的伤口或伴有感染性血管移植物并发症的伤口中的作用尚未明确界定。一个多学科咨询小组回顾了与血管外科手术及并发症相关伤口的文献,重点关注大皮下血管或感染性血管导管。文献支持的结果以及共识小组的临床实践表明,NPWT可作为腹股沟血管感染和裂开处理的有用辅助手段,但必须谨慎使用。