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改良根治性乳房切除术后伤口处理中闭式负压引流与闭式单纯引流的比较

Closed suction drainage versus closed simple drainage in the management of modified radical mastectomy wounds.

作者信息

Ezeome E R, Adebamowo C A

机构信息

Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.

出版信息

S Afr Med J. 2008 Sep;98(9):712-5.

Abstract

OBJECTIVE

To compare the outcomes of modified radical mastectomy wounds managed by closed wound drainage with suction and without suction.

METHOD

A prospective randomised trial was conducted at the University College Hospital in Ibadan, and the University of Nigeria Teaching Hospital in Enugu. Fifty women who required modified radical mastectomy for breast cancer were randomised to have closed wound drainage with suction (26 patients) and closed wound drainage without suction (24 patients).

RESULTS

There was no significant difference in the intraoperative and postoperative variables. Suction drainage drained less volume of fluid and stayed for a shorter time in the wound, but the differences were not significant. There was no difference in the length of hospital stay, time to stitch removal, and number of dressing changes. More haematomas and wound infections occurred in the simple drain group while more seromas occurred in the suction drain group, but these were not significant. The suction drain was more difficult to manage and the cost was 15 times higher than the simple drainage system.

CONCLUSION

Closed simple drains are not inferior to suction drains in mastectomy wounds and, considering the cost saving and simplicity of postoperative care, they are preferable to suction drains.

摘要

目的

比较采用有负压吸引和无负压吸引的闭合式伤口引流处理改良根治性乳房切除术后伤口的效果。

方法

在伊巴丹大学学院医院和埃努古尼日利亚大学教学医院进行了一项前瞻性随机试验。50名因乳腺癌需要进行改良根治性乳房切除术的女性被随机分为两组,一组采用有负压吸引的闭合式伤口引流(26例患者),另一组采用无负压吸引的闭合式伤口引流(24例患者)。

结果

术中及术后各项变量无显著差异。负压吸引引流的液体量较少,在伤口内留置时间较短,但差异不显著。住院时间、拆线时间和换药次数无差异。单纯引流组血肿和伤口感染较多,而负压吸引引流组血清肿较多,但这些差异均不显著。负压吸引引流管理更困难,成本比单纯引流系统高15倍。

结论

在乳房切除术后伤口中,单纯闭合式引流并不逊色于负压吸引引流,考虑到成本节约和术后护理的简便性,单纯闭合式引流优于负压吸引引流。

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