Witt-Majchrzak Anna, Żelazny Piotr, Snarska Jadwiga
Pol Przegl Chir. 2015 Feb 3;86(10):456-65. doi: 10.2478/pjs-2014-0082.
Hospital infections, and in particular infections of the surgical site are a common problem of the procedural departments. Due to continuous progress of surgical techniques and patient population getting older with multiple co-morbidities, multidirectional actions need to be taken to avoid these infections or, if they do occur, achieve optimal treatment outcomes. Vacuum wound therapy is one of the directions that has been developed over the recent years. The aim of the study evaluate wound healing in patients after an off-pump coronary artery bypass grafting procedure, using the internal mammary artery, treated with negative pressure wound therapy system.
This prospective, open label study evaluated healing of postoperative sternotomy wounds after their primary closure with negative pressure wound therapy, using continuous negative pressure of -80 mmHg in 40 patients and 40 patients in a control group in whom conventional dressings were applied in the postoperative period.
The number of patients in whom primary wound healing occurred without complications was significantly higher in the negative pressure wound therapy group versus the control group (x2 test =4.50, p=0.0339) and the number of total superficial infections was significantly smaller versus the control group (x2 test =5; p=0.0254). Antibiotic therapy was also initiated significantly less often as compared to the group treated with conventional dressings (x2 test = 4.11; p=0.0425).
Negative pressure wound therapy after primary wound closure reduces the risk of superficial infections in the population with multiple risk factors of complications in the sternotomy wound healing.
医院感染,尤其是手术部位感染,是手术科室常见的问题。由于手术技术的不断进步以及患者年龄增长且伴有多种合并症,需要采取多方面措施来避免这些感染,或者在感染发生时实现最佳治疗效果。负压伤口治疗是近年来发展起来的方向之一。本研究的目的是评估在非体外循环冠状动脉搭桥手术中使用乳内动脉并接受负压伤口治疗系统治疗的患者的伤口愈合情况。
这项前瞻性、开放标签研究评估了40例患者在术后使用负压伤口治疗进行一期缝合后胸骨切开术伤口的愈合情况,持续负压为 -80 mmHg,另有40例患者作为对照组,术后使用传统敷料。
负压伤口治疗组一期伤口愈合且无并发症的患者数量显著高于对照组(χ²检验 = 4.50,p = 0.0339),浅表感染总数显著少于对照组(χ²检验 = 5;p = 0.0254)。与使用传统敷料治疗的组相比,抗生素治疗的启动频率也显著更低(χ²检验 = 4.11;p = 0.0425)。
一期伤口缝合后进行负压伤口治疗可降低胸骨切开术伤口愈合中具有多种并发症危险因素人群的浅表感染风险。