Costello J P, Amling J K, Emerson D A, Peer S M, Afflu D K, Zurakowski D, Jonas R A, Nath D S
MD, Division of Cardiovascular Surgery, Childrens National Health System, Washington DC, US, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Childrens National Health System, Washington DC, US.
RN, MSN, Wound and Surgical Airway Program, Childrens National Health System, Washington DC, US.
J Wound Care. 2014 Jan;23(1):31-6. doi: 10.12968/jowc.2014.23.1.31.
This study examines the efficacy of a comprehensive, multidisciplinary wound management team and negative pressure wound therapy (NPWT) for the treatment of sternal wound infections in congenital heart surgery patients.
A single-institution retrospective review of all congenital heart surgery patients with post-operative sternal wound infections who were treated with NPWT was performed. Patients were evaluated based on (a) whether NPWT occurred before or after the establishment of a multidisciplinary wound management team, and (b) whether NPWT was initiated early (within 2 days) or late (greater than 2 days) after diagnosis of a sternal wound infection.
The median duration of NPWT was 12 days (range 2-50 days). NPWT was successfully initiated in patients as young as 15 days of age. There was a trend toward shorter duration of both NPWT and antibiotic use following (a) the implementation of the multidisciplinary wound management team, and (b) in patients with early use of NPWT; however, these results did not achieve statistical significance.
NPWT can be successfully utilised in congenital heart surgery patients, including young neonates, for the treatment of sternal wound infections. The trends observed in the reduction of wound therapy duration and antibiotic duration with early implementation of negative pressure therapy and multidisciplinary wound management require further investigation to verify their clinical efficacy in patient care.
本研究探讨综合多学科伤口管理团队和负压伤口治疗(NPWT)对先天性心脏病手术患者胸骨伤口感染的治疗效果。
对所有接受NPWT治疗的先天性心脏病手术后发生胸骨伤口感染的患者进行单机构回顾性研究。根据以下因素对患者进行评估:(a)NPWT是在多学科伤口管理团队成立之前还是之后进行的;(b)NPWT是在诊断胸骨伤口感染后早期(2天内)还是晚期(超过2天)开始的。
NPWT的中位持续时间为12天(范围2 - 50天)。NPWT在年仅15天的患者中也成功启动。在(a)实施多学科伤口管理团队后,以及(b)早期使用NPWT的患者中,NPWT和抗生素使用的持续时间有缩短的趋势;然而,这些结果未达到统计学意义。
NPWT可成功用于先天性心脏病手术患者,包括新生儿,以治疗胸骨伤口感染。早期实施负压治疗和多学科伤口管理在缩短伤口治疗时间和抗生素使用时间方面观察到的趋势,需要进一步研究以验证其在患者护理中的临床疗效。