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剖腹切口高危患者应用负压治疗预防手术部位感染。

Prevention of surgical site infections in high-risk patients with laparotomy incisions using negative-pressure therapy.

机构信息

Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.

出版信息

Am J Surg. 2013 Jun;205(6):647-54. doi: 10.1016/j.amjsurg.2012.06.007. Epub 2013 Jan 30.

Abstract

BACKGROUND

This study evaluates the efficacy of negative-pressure therapy (NPT) in preventing surgical site infections (SSIs) in high-risk surgical oncology patients.

METHODS

A retrospective analysis of 191 operations for colorectal, pancreatic, or peritoneal surface malignancies was performed. Incisional NPT was used in patients with multiple SSI risk factors. Rates of SSIs were compared with patients treated with a standard sterile dressing (SSD).

RESULTS

NPT was used in 104 patients, whereas SSDs were used in 87 patients. Despite being at an increased risk of SSI, patients treated with NPT developed fewer superficial incisional SSIs compared with SSD patients (6.7% vs 19.5%, P = .015). In a subgroup analysis of clean-contaminated cases, NPT was associated with fewer superficial incisional SSIs (6.0% vs 27.4%, P = .001), fewer total SSIs (16.0% vs 35.5%, P = .011), and fewer wound openings for any reason (16.0% vs 35.5%, P = .011).

CONCLUSIONS

Our findings suggest that NPT decreases SSIs in high-risk surgical oncology patients.

摘要

背景

本研究评估了负压治疗(NPT)在预防高风险外科肿瘤患者手术部位感染(SSI)中的疗效。

方法

对 191 例结直肠、胰腺或腹膜表面恶性肿瘤手术进行回顾性分析。对于具有多种 SSI 风险因素的患者,使用切口 NPT。比较了 NPT 组与使用标准无菌敷料(SSD)治疗的患者的 SSI 发生率。

结果

NPT 组有 104 例患者,SSD 组有 87 例患者。尽管 NPT 组患者发生 SSI 的风险增加,但与 SSD 组患者相比,浅层切口 SSI 发生率较低(6.7%比 19.5%,P =.015)。在清洁污染病例的亚组分析中,NPT 与较少的浅层切口 SSI(6.0%比 27.4%,P =.001)、较少的总 SSI(16.0%比 35.5%,P =.011)和更少的任何原因的伤口开放(16.0%比 35.5%,P =.011)相关。

结论

我们的研究结果表明,NPT 可降低高风险外科肿瘤患者的 SSI。

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