Muensterer Oliver J, Keijzer Richard
Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
JSLS. 2011 Apr-Jun;15(2):147-50. doi: 10.4293/108680811X13071180406592.
After introducing single-incision pediatric endosurgical (SIPES) appendectomy at our institution, we noticed an increased number of post-operative umbilical infections. This study evaluates the impact of a simple, low-cost wound vacuum dressing on the wound infection rate.
Umbilical wounds after single-incision laparoscopic appendectomy were covered with standard dressing (approximating strips), or the new umbilical vacuum dressing. A wound infection was defined as an infected umbilicus requiring antibiotics, or incision and drainage. The wound infection rate was compared between both groups. Statistical analysis was performed using Fischer's exact test. Continuous variables were compared using the Student t test.
Included in this study were 183 children, 97 of whom were treated with the vacuum dressing. The study populations were no different in terms of age, weight, operative time, blood loss, length of stay, or proportion of acute versus perforated appendicitis. A total of 7 (3.8%) wound infections occurred, 1 in the vacuum dressing group (1%), versus 6 in the conventional dressing group (7%, P=0.038).
This simple, low-cost umbilical vacuum dressing decreased the wound infection rate after SIPES appendectomy, possibly by absorbing secretions from the base of the wound. It may be equally effective for other indications.
在我们机构引入单切口小儿内镜手术(SIPES)阑尾切除术后,我们注意到术后脐部感染的数量有所增加。本研究评估一种简单、低成本的伤口负压敷料对伤口感染率的影响。
单切口腹腔镜阑尾切除术后的脐部伤口用标准敷料(近似条带)或新型脐部负压敷料覆盖。伤口感染定义为需要使用抗生素、切开引流的脐部感染。比较两组的伤口感染率。采用Fisher精确检验进行统计分析。连续变量采用Student t检验进行比较。
本研究纳入183名儿童,其中97名接受了负压敷料治疗。研究人群在年龄、体重、手术时间、失血量、住院时间或急性阑尾炎与穿孔性阑尾炎的比例方面无差异。共发生7例(3.8%)伤口感染,负压敷料组1例(1%),传统敷料组6例(7%,P = 0.038)。
这种简单、低成本的脐部负压敷料降低了SIPES阑尾切除术后的伤口感染率,可能是通过吸收伤口底部的分泌物实现的。它对其他适应证可能同样有效。