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负压伤口治疗与纱布敷料治疗污染性创伤伤口的比较。

Negative pressure wound therapy versus gauze dressings for the treatment of contaminated traumatic wounds.

作者信息

Kaushik D, Joshi N, Kumar R, Gaba S, Sapra R, Kumar K

机构信息

Senior Resident, Sports Injury Centre, Safdarjung Hospital, New Delhi, India.

Professor, Sawai Man Singh Medical College and Hospital, Rajasthan, India.

出版信息

J Wound Care. 2017 Oct 2;26(10):600-606. doi: 10.12968/jowc.2017.26.10.600.

Abstract

OBJECTIVE

This compares hospital suction negative pressure wound therapy (NPWT) with conventional gauze dressings in traumatic soft-tissue injury at a tertiary care centre.

METHODS

A prospective control study was conducted between September 2012 and November 2014. Patients with one or more traumatic soft-tissue injuries with contaminated wounds were allocated to either a test group (received NPWT) or control group (received conventional gauze). Wounds were assessed by two orthopaedic surgeons. If grade A was achieved, the wound was covered with split-thickness skin graft, flap or delayed primary closure; otherwise, revision debridement and NPWT/saline gauze dressings were applied. Descriptive statistics (mean, standard deviation and proportions) were used to summarise the study variables. The 95% confidence intervals (CI) for difference of mean were used. Chi-square test and Fisher's exact test were used to observe an association between the qualitative data and outcome variables. Unpaired T-Test and Mann-Whitney U test were used for analysis of the quantitative data. A p<0.05 was considered statistically significant.

RESULTS

A total of 104 patients were included. The mean number of dressings per patient was significantly lower in the NPWT group (3.4) than in the control group (20.7) (p<0.001). The time between injury and complete closure (12.5 versus 21.4 days) as well as duration of hospital stay (17.3 versus 23.8 days) was significantly less in the NPWT group (p<0.05).

CONCLUSION

NPWT has a role in healing traumatic wounds and can be delivered effectively through hospital suction NPWT, which can also reduce the cost of therapy. We recommend its regular use in all patients presenting with post-traumatic, soft-tissue injuries when primary coverage is not possible.

摘要

目的

在一家三级医疗中心比较医院负压伤口治疗(NPWT)与传统纱布敷料用于创伤性软组织损伤的效果。

方法

于2012年9月至2014年11月进行一项前瞻性对照研究。将有一处或多处伴有污染伤口的创伤性软组织损伤患者分为试验组(接受NPWT)或对照组(接受传统纱布)。由两名骨科医生对伤口进行评估。若达到A级,伤口用中厚皮片移植、皮瓣或二期延迟缝合覆盖;否则,进行清创术及NPWT/生理盐水纱布敷料处理。采用描述性统计(均值、标准差和比例)来总结研究变量。使用均值差异的95%置信区间(CI)。采用卡方检验和费舍尔精确检验观察定性数据与结果变量之间的关联。采用非配对T检验和曼-惠特尼U检验分析定量数据。p<0.05被认为具有统计学意义。

结果

共纳入104例患者。NPWT组患者的平均换药次数(3.4次)显著低于对照组(20.7次)(p<0.001)。NPWT组受伤至完全愈合的时间(12.5天对21.4天)以及住院时间(17.3天对23.8天)显著更短(p<0.05)。

结论

NPWT在创伤性伤口愈合中发挥作用,可通过医院负压NPWT有效实施,还可降低治疗成本。我们建议在所有无法进行一期覆盖的创伤后软组织损伤患者中常规使用NPWT。

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