Dorafshar Amir H, Franczyk Mieczyslawa, Gottlieb Lawrence J, Wroblewski Kristen E, Lohman Robert F
Division of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institute, Baltimore, MD, USA.
Ann Plast Surg. 2012 Jul;69(1):79-84. doi: 10.1097/SAP.0b013e318221286c.
Two methods of subatmospheric pressure wound therapy--wall suction applied to a sealed gauze dressing (GSUC) and the vacuum-assisted closure device (VAC)--were compared in hospitalized patients at University of Chicago Medical Center.
VAC therapy is widely used, but can be expensive and difficult to apply; it also fails in some patients.
A randomized prospective study of 87 patients (N = 45 in the GSUC arm and N = 42 in the VAC arm) was undertaken between October 2006 and May 2008. The study comprised patients with acute wounds resulting from trauma, dehiscence, or surgery.
Demographics and wound characteristics were similar in both groups. There were significant reductions in wound surface area and volume in each group. In the GSUC group, the reductions in wound surface area and volume were 4.5%/day and 8.4%/day, respectively (P < 0.001 for both), and in the VAC group, this was 4.9%/day and 9.8%/day, respectively (P < 0.001 for both). The reductions in wound surface area and volume were similar in both groups (P = 0.60 and 0.19, respectively, for the group-by-time interaction). The estimated difference (VAC - GSUC) was 0.4% (95% confidence interval: -1.0, 1.7) for wound surface area and 1.4% (95% confidence interval: -0.7, 3.5) for volume. The mean cost per day for GSUC therapy was $4.22 versus $96.51 for VAC therapy (P < 0.01) and the average time required for a GSUC dressing change was 19 minutes versus 31 minutes for a VAC dressing change (P < 0.01). The sum of pain intensity differences was 0.50 in the GSUC group compared with 1.73 for the VAC group (P = 0.02).
GSUC is noninferior to VAC with respect to changes in wound volume and surface area in an acute care setting. In addition, GSUC dressings were easier to apply, less expensive, and less painful.
在芝加哥大学医学中心的住院患者中，比较两种负压伤口治疗方法——应用于密封纱布敷料的壁式吸引（GSUC）和真空辅助闭合装置（VAC）。
VAC疗法被广泛使用，但可能成本高昂且应用困难；在一些患者中也会失败。
在2006年10月至2008年5月期间，对87例患者进行了一项随机前瞻性研究（GSUC组45例，VAC组42例）。该研究纳入了因创伤、切口裂开或手术导致急性伤口的患者。
两组的人口统计学和伤口特征相似。每组的伤口表面积和体积均有显著减少。在GSUC组，伤口表面积和体积的减少率分别为每天4.5%和8.4%（两者P均<0.001），在VAC组，分别为每天4.9%和9.8%（两者P均<0.001）。两组伤口表面积和体积的减少相似（组间时间交互作用的P值分别为0.60和0.19）。伤口表面积的估计差异（VAC - GSUC）为0.4%（95%置信区间：-1.0，1.7），体积差异为1.4%（95%置信区间：-0.7，3.5）。GSUC疗法的日均成本为4.22美元，而VAC疗法为96.51美元（P<0.01），GSUC换药平均所需时间为19分钟，而VAC换药为31分钟（P<0.01）。GSUC组疼痛强度差异总和为0.50，而VAC组为1.73（P = 0.02）。
在急性护理环境中，就伤口体积和表面积的变化而言，GSUC不劣于VAC。此外，GSUC敷料应用更简便、成本更低且疼痛更小。
