使用手术切口管理系统预防胸骨伤口感染：澳大利亚首例病例系列报告
Prevention of Sternal Wound Infections by use of a Surgical Incision Management System: First Reported Australian Case Series.
作者信息
Jennings Scott, Vahaviolos Jim, Chan Justin, Worthington Michael G, Stuklis Robert G
机构信息
D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, SA.
D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, SA.
出版信息
Heart Lung Circ. 2016 Jan;25(1):89-93. doi: 10.1016/j.hlc.2015.06.821. Epub 2015 Jul 14.
BACKGROUND
Sternal wound infections are considered a costly and potentially devastating consequence of the median sternotomy in cardiothoracic surgery. Surgical incision management employs the technique of applying a closed, negative pressure vacuum dressing to a closed wound. Several studies have demonstrated a reduction in sternal wound infections using this system.
METHODS
A retrospective audit of cases receiving surgical incision management demonstrated a statistically significant reduction in sternal wound infections against a predicted rate.
RESULTS
Of the 62 patients identified, only one was complicated by a sternal wound infection with the greatest reduction seen in the high-risk infection group.
CONCLUSIONS
Although smaller in size, the results compared well to trials conducted in larger European and US centres. Although not advocating surgical incision management for routine use, it should be considered on patients considered high-risk for sternal wound infection, such as diabetics, the elderly and the obese.
背景
胸骨伤口感染被认为是心胸外科正中开胸手术代价高昂且可能带来严重后果的并发症。手术切口管理采用对闭合伤口应用封闭的负压真空敷料的技术。多项研究表明使用该系统可减少胸骨伤口感染。
方法
对接受手术切口管理的病例进行回顾性审计，结果显示与预测发生率相比，胸骨伤口感染有统计学意义的显著减少。
结果
在确定的62例患者中，仅1例发生胸骨伤口感染并发症，高危感染组的感染减少最为明显。
结论
尽管样本量较小，但结果与在欧洲和美国较大中心进行的试验相当。虽然不主张将手术切口管理常规应用，但对于被认为有胸骨伤口感染高风险的患者，如糖尿病患者、老年人和肥胖者，应考虑采用该方法。
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