Boston, Mass. From the Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School.
Plast Reconstr Surg. 2011 Jan;127 Suppl 1:105S-115S. doi: 10.1097/PRS.0b013e318200a427.
Over the last 15 years, negative-pressure wound therapy has become commonly used for treatment of a wide variety of complex wounds. There are now several systems marketed, and additional products will be available in the near future. Many clinicians have noted a dramatic response when negative-pressure wound therapy technology has been used, prompting a number of scientific investigations related to its mechanism of action and clinical trials determining its efficacy.
The peer-reviewed literature within the past 5 years was reviewed, using an evidence-based approach.
Negative-pressure wound therapy works through mechanisms that include fluid removal, drawing the wound together, microdeformation, and moist wound healing. Several randomized clinical trials support the use of negative-pressure wound therapy in certain wound types. Serious complications, including bleeding and infection, have recently been reported by the U.S. Food and Drug Administration in a small number of patients.
Negative-pressure wound therapy has dramatically changed the way complex wounds are treated. The rapid introduction of this technology has occurred faster than large-scale randomized controlled studies or registry studies have been conducted. Further clinical studies and basic science studies will help surgeons to better understand the evidence and use this technology in the future.
在过去的 15 年中，负压伤口疗法已被广泛用于治疗各种复杂的伤口。目前市场上有多种系统，并且在不久的将来还会有更多的产品问世。许多临床医生在使用负压伤口疗法技术时都注意到了明显的效果，这促使人们进行了许多与该技术的作用机制相关的科学研究，并开展了临床试验以确定其疗效。
使用循证方法回顾了过去 5 年内的同行评审文献。
负压伤口疗法通过包括清除液体、使伤口合拢、微变形和湿性愈合等机制发挥作用。一些随机临床试验支持在某些类型的伤口中使用负压伤口疗法。美国食品和药物管理局最近在少数患者中报告了一些严重的并发症，包括出血和感染。
负压伤口疗法已极大地改变了复杂伤口的治疗方式。该技术的快速引入速度比大规模随机对照研究或注册研究的开展速度还要快。进一步的临床研究和基础科学研究将有助于外科医生更好地理解证据，并在未来使用该技术。
