OSU Eye and Ear Institute, 915 Olentangy River Rd, Ste 4000, Columbus, OH 43212, USA.
Otolaryngol Head Neck Surg. 2010 Feb;142(2):174-8. doi: 10.1016/j.otohns.2009.11.003.
Randomized, controlled trial.
Tertiary care hospital.
After the study was approved, consenting adults undergoing RFFF for head and neck reconstructions were randomized into two arms: SPD and NPD groups. Fifty-four patients were enrolled from March 2007 to August 2009. Pre- and postoperative data were collected, including medical comorbidities, graft size, and area of graft failure/tendon exposure. Data were collected at two postoperative time points.
The overall wound complication rate was 38 percent (19/50). Wound complications at the first postoperative visit (44.4% [12/27] SPD and 30.4% [7/23] NPD) were not significantly different between groups (P = 0.816). Similarly, wound complications at the second visit (68.8% [11/16] SPD and 80% [12/15] NPD) were not significantly different (P = 0.55). Percentage of area of graft failure between the groups also showed no difference (4.5% SPD vs 7.2% NPD, P = 0.361). The association of graft size with wound complications was analyzed by dividing the data set into three groups (<50 cm(2), 51-100 cm(2), and >100 cm(2)). This difference was not found to be significant (P = 0.428). Finally, when evaluating comorbidities, 50 percent (8/16) of subjects with comorbidities experienced complications compared with 32.4 percent (11/34) without comorbidities, also not reaching significance (P = 0.203).
Although an attractive option for wound care, the NPD does not appear to offer a significant improvement over an SPD in healing of the RFFF donor site.
1）比较使用负压敷料（NPD）与静态压力敷料（SPD）时桡侧前臂游离皮瓣（RFFF）供区的植皮愈合情况。2）研究移植物大小和合并症与 RFFF 供区愈合的关系。
随机对照试验。
三级保健医院。
在研究获得批准后，同意接受 RFFF 进行头颈部重建的成年人被随机分为两组：SPD 和 NPD 组。2007 年 3 月至 2009 年 8 月共纳入 54 例患者。收集术前和术后数据，包括合并症、移植物大小和移植物失败/肌腱暴露面积。在两个术后时间点收集数据。
总伤口并发症发生率为 38%（19/50）。首次术后就诊时的伤口并发症（SPD 组 44.4%[12/27]，NPD 组 30.4%[7/23]）在两组之间无显著差异（P=0.816）。同样，第二次就诊时的伤口并发症（SPD 组 68.8%[11/16]，NPD 组 80%[12/15]）也无显著差异（P=0.55）。两组间移植物失败面积百分比也无差异（SPD 组 4.5%，NPD 组 7.2%，P=0.361）。通过将数据集分为三组（<50cm2、51-100cm2 和>100cm2）来分析移植物大小与伤口并发症的关系，差异无统计学意义（P=0.428）。最后，在评估合并症时，50%（8/16）的合并症患者发生并发症，而无合并症患者的这一比例为 32.4%（11/34），差异也无统计学意义（P=0.203）。
尽管负压敷料是一种有吸引力的伤口护理选择，但与 SPD 相比，它似乎并没有显著改善 RFFF 供区的愈合。
