Wallin Ann-Mari, Boström Lennart, Ulfvarson Johanna, Ottosson Carin
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet Södersjukhuset, S-118 83 Stockholm, Sweden.
Ostomy Wound Manage. 2011 Jun;57(6):22-9.
To address a persistent lack of evidence regarding the clinical outcomes of negative pressure wound therapy (NPWT) and identify which patient groups are most likely to benefit from NPWT, a retrospective, descriptive study was conducted to describe outcomes of this treatment modality when used in clinical practice. Charts from a consecutive series of 87 patients (median age 68 years, range 16 - 92 years) who received NPWT during a period of 24 months were abstracted to a statistical software file. Patient demographics, history, and comorbidity variables as well as treatment outcomes were obtained from the computerized in- and outpatient record system. Treatment outcomes were grouped as successful (goal of care was met) or not successful (goal of care was not met). Successful treatment was noted for a total of 62 patients (71%) with a median treatment time of 17 days. The proportion of patients with a successful outcome was significantly higher in patients with infectious, postoperative, and traumatic wounds than in patients with wounds related to peripheral vascular disease or pressure ulcers (P = 0.001). Treatment complications were observed in 18 patients (21%); five were related to infection. Quality-of-life concerns were noted as a reason for stopping treatment in four patients and equipment problems were recorded for two patients receiving NPWT in the home. This study confirms previous re- search that NPWT may be an effective and safe treatment method for acute wounds but further studies are needed to evaluate treatment efficacy and effectiveness in patients with peripheral vascular disease or pressure-induced wounds. Results also suggest that research protocols should include patient quality-of-life outcomes.
为了解决负压伤口治疗(NPWT)临床结果方面长期缺乏证据的问题,并确定哪些患者群体最有可能从NPWT中获益,我们进行了一项回顾性描述性研究,以描述这种治疗方式在临床实践中的效果。从连续87例患者(中位年龄68岁,范围16 - 92岁)在24个月期间接受NPWT的病历中提取数据,录入统计软件文件。患者的人口统计学信息、病史、合并症变量以及治疗结果均从计算机化的门诊和住院记录系统中获取。治疗结果分为成功(达到护理目标)或不成功(未达到护理目标)。共有62例患者(71%)治疗成功,中位治疗时间为17天。感染性、术后和创伤性伤口患者的成功治疗比例显著高于外周血管疾病或压疮相关伤口患者(P = 0.001)。18例患者(21%)出现治疗并发症;5例与感染有关。4例患者因生活质量问题而停止治疗,2例接受家庭NPWT治疗的患者记录有设备问题。本研究证实了先前的研究结果,即NPWT可能是治疗急性伤口的一种有效且安全的方法,但需要进一步研究来评估其对外周血管疾病或压力性伤口患者的治疗效果和有效性。结果还表明,研究方案应纳入患者生活质量结果。