Yu Yongchao, Song Zhigang, Xu Zhiyun, Ye Xiaofei, Xue Chunyu, Li Junhui, Bi Hongda
Department of Cardiac Surgery Department of Statistics, Faculty of Medical Services Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Medicine (Baltimore). 2017 Jan;96(3):e5925. doi: 10.1097/MD.0000000000005925.
The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial.
A single-center, pilot randomized controlled trial was conducted. From December 2013 to March 2014, a total of 72 coronary heart disease patients (48 men and 24 women) received CABG therapy, with great saphenous veins were selected as grafts. Patients were equally randomized into a treatment and a control group. After the harvesting of the great saphenous veins and direct closure of the wound with sutures, b-NPWT was used for the thigh incision in the treatment group for 5 days (treatment thigh). Traditional surgical pads were applied to both the shank incisions of the treatment group patients (treatment shank) and the entire incisions of the control group (control thigh, control shank). Postoperative complications were recorded and statistically analyzed based on outcomes of thigh treatment, shank treatment, thigh control, and shank control groups.
The incidence rates of early complications, such as lymphorrhagia, lymphoedema, infection, wound dehiscence, and skin flap necrosis, of the vascular donor site in the thigh treatment group was significantly lower than those in the 3 other groups.
The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting.
ClinicalTrials.gov. The unique registration number is NCT02010996.
对于接受冠状动脉旁路移植术（CABG）的患者而言，采集大隐静脉可能会引发严重并发症，包括淋巴漏、淋巴水肿、切口感染、伤口裂开以及皮瓣坏死。我们通过一项临床随机对照试验，研究了自行设计的双层负压伤口治疗（b-NPWT）在减少上述并发症方面的作用。
开展了一项单中心、试点随机对照试验。2013年12月至2014年3月，共有72例冠心病患者（48例男性和24例女性）接受了CABG治疗，选取大隐静脉作为移植血管。患者被随机分为治疗组和对照组。在采集大隐静脉并用缝线直接缝合伤口后，治疗组的大腿切口使用b-NPWT治疗5天（治疗大腿）。治疗组患者的小腿切口（治疗小腿）和对照组的整个切口（对照大腿、对照小腿）均使用传统手术垫。根据大腿治疗组、小腿治疗组、大腿对照组和小腿对照组的结果记录并统计分析术后并发症。
大腿治疗组血管供区早期并发症（如淋巴漏、淋巴水肿、感染、伤口裂开和皮瓣坏死）的发生率显著低于其他3组。
自行设计的b-NPWT可有效减少接受大隐静脉采集的CABG患者术后的并发症，如淋巴水肿、切口感染、伤口裂开和皮瓣坏死。
ClinicalTrials.gov。唯一注册号为NCT02010996。
