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新型负压切口管理系统用于高危患者心脏手术后手术切口的首次经验。

First experience with a new negative pressure incision management system on surgical incisions after cardiac surgery in high risk patients.

作者信息

Colli Andrea, Camara Maria-Luisa

机构信息

Department of Cardiac Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

出版信息

J Cardiothorac Surg. 2011 Dec 6;6:160. doi: 10.1186/1749-8090-6-160.

Abstract

BACKGROUND

Sternal wound infection remains a serious potential complication after cardiac surgery. A recent development for preventing wound complications after surgery is the adjunctive treatment of closed incisions with negative pressure wound therapy. Suggested mechanisms of preventive action are improving the local blood flow, removing fluids and components in these fluids, helping keep the incision edges together, protecting the wound from external contamination and promoting incision healing. This work reports on our initial evaluation and clinical experience with the Prevena™Incision Management System, a recently introduced new negative pressure wound therapy system specifically developed for treating closed surgical incisions and helping prevent potential complications. We evaluated the new treatment on sternal surgical incisions in patients with multiple co-morbidities and consequently a high risk for wound complications.

METHODS

The Prevena™incision management system was used in 10 patients with a mean Fowler risk score of 15.1 [Range 8-30]. The negative pressure dressing was applied immediately after surgery and left in place for 5 days with a continuous application of -125 mmHg negative pressure. Wounds and surrounding skin were inspected immediately after removal of the Prevena™ incision management system and at day 30 after surgery.

RESULTS

Wounds and surrounding skin showed complete wound healing with the absence of skin lesions due to the negative pressure after removal of the Prevena™ dressing. No device-related complications were observed. No wound complications occurred in this high risk group of patients until at least 30 days after surgery.

CONCLUSIONS

The Prevena™system appears to be safe, easy to use and may help achieve uncomplicated wound healing in patients at risk of developing wound complications after cardiothoracic surgery.

摘要

背景

胸骨伤口感染仍然是心脏手术后严重的潜在并发症。术后预防伤口并发症的一项最新进展是采用负压伤口治疗辅助处理闭合切口。其预防作用的推测机制包括改善局部血流、清除液体及其成分、帮助保持切口边缘贴合、保护伤口免受外部污染以及促进切口愈合。本文报告了我们对Prevena™切口管理系统的初步评估和临床经验,这是一种最近推出的新型负压伤口治疗系统,专门用于治疗闭合手术切口并帮助预防潜在并发症。我们在患有多种合并症且因此伤口并发症风险较高的患者的胸骨手术切口中评估了这种新治疗方法。

方法

10例患者使用了Prevena™切口管理系统,平均Fowler风险评分为15.1[范围8 - 30]。术后立即应用负压敷料,并持续施加-125 mmHg负压,留置5天。在移除Prevena™切口管理系统后及术后第30天立即检查伤口及周围皮肤。

结果

移除Prevena™敷料后,伤口及周围皮肤显示伤口完全愈合,且无因负压导致的皮肤病变。未观察到与设备相关的并发症。在这组高风险患者中,至少术后30天内未发生伤口并发症。

结论

Prevena™系统似乎安全、易于使用,可能有助于在心胸外科手术后有发生伤口并发症风险的患者中实现无并发症的伤口愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b81/3305521/f206fa538658/1749-8090-6-160-1.jpg

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