负压伤口疗法在新生儿和婴儿腹部伤口中的应用。

Use of negative pressure wound therapy for abdominal wounds in neonates and infants.

机构信息

Department of Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.

出版信息

J Pediatr Surg. 2012 Aug;47(8):1555-9. doi: 10.1016/j.jpedsurg.2012.01.014.

DOI:10.1016/j.jpedsurg.2012.01.014

PMID:22901916

Abstract

BACKGROUND

Negative pressure wound therapy (NPWT) is an established and effective tool in the management of complicated abdominal wounds. This management approach has been used in infants, but few large series reports exist in the literature.

METHODS

The outcomes of infants with abdominal wounds receiving NPWT over the last 10 years at our institution were evaluated. Overall survival, time between initiation of NPWT, and discharge/death were examined.

RESULTS

We identified 18 infants who had abdominal wounds treated with NPWT. Diagnoses were varied, as was the duration of therapy. The median NPWT duration of treatment was 34.0 ± 92.1 days. Forty-four percent of the infants had a stoma before application of NPWT, and 22% of the infants had enterocutaneous fistulas before use of NPWT. There were only 2 cases in which a new fistula developed during the use of NPWT, and both of these omphalopagus conjoined twins had undergone the Bianchi procedure. No additional NPWT-related complications were identified. Of 18 infants, 6 died in this cohort.

CONCLUSION

Negative pressure wound therapy is an important therapeutic tool for the management of abdominal wounds in infants.

摘要

背景

负压伤口疗法（NPWT）是治疗复杂腹部伤口的一种成熟且有效的方法。这种治疗方法已在婴儿中应用，但文献中鲜有大样本系列报告。

方法

评估了过去 10 年在我院接受 NPWT 治疗的腹部伤口婴儿的结局。评估了总体生存率、NPWT 开始至出院/死亡的时间。

结果

我们共确定了 18 例接受 NPWT 治疗的腹部伤口婴儿。诊断各不相同，治疗时间也不同。NPWT 治疗的中位时间为 34.0±92.1 天。44%的婴儿在应用 NPWT 前有造口，22%的婴儿在应用 NPWT 前有肠皮肤瘘。只有 2 例在应用 NPWT 期间出现新瘘，这 2 例均为脐膨出联体双胎，且均行了 Bianchi 手术。未发现其他与 NPWT 相关的并发症。在这组 18 例婴儿中，有 6 例死亡。