Department of Vascular Surgery, Jung-Stilling Hospital, Siegen, Germany.
Department of Cardiovascular Surgery, University Hospital, Justus Liebig University, Giessen, Germany.
Int Wound J. 2018 Feb;15(1):75-83. doi: 10.1111/iwj.12836. Epub 2017 Oct 25.
Groin wound infections in patients undergoing vascular procedures often cause a lengthy process of wound healing. Several clinical studies and case reports show a reduction of surgical site infections (SSIs) in various wound types after using closed incision negative pressure therapy (ciNPT). The aim of this prospective, randomised, single-institution study was to investigate the effectiveness of ciNPT (PREVENA™ Therapy) compared to conventional therapy on groin incisions after vascular surgery. From 1 February to 30 October 2015, 100 patients with 129 groin incisions were analysed. Patients were randomised and treated with either ciNPT (n = 58 groins) or the control dressing (n = 71 groins). ciNPT was applied intraoperatively and removed on days 5-7 postoperatively. The control group received a conventional adhesive plaster. Wound evaluation based on the Szilagyi classification took place postoperatively on days 5-7 and 30. Compared to the control group, the ciNPT group showed a significant reduction in wound complications (P < 0·0005) after both wound evaluation periods and in revision surgeries (P = 0·022) until 30 days postoperatively. Subgroup analysis revealed that ciNPT had a significant effect on almost all examined risk factors for wound healing. ciNPT significantly reduced the incidence of incision complications and revision procedures after vascular surgery.
股部切口感染常导致血管手术患者的伤口愈合过程延长。多项临床研究和病例报告显示,在各种类型的伤口中使用密闭式切口负压治疗(ciNPT)可降低手术部位感染(SSI)的发生率。本前瞻性、随机、单中心研究旨在评估 ciNPT(PREVENA™ 治疗)与传统疗法在血管手术后股部切口的有效性。2015 年 2 月 1 日至 10 月 30 日,分析了 100 例 129 个股部切口的患者。患者随机分为 ciNPT 组(n = 58 个切口)和对照组(n = 71 个切口)。ciNPT 在术中应用,并于术后第 5-7 天去除。对照组接受常规粘性绷带。术后第 5-7 天和第 30 天采用 Szilagyi 分类法对伤口进行评估。与对照组相比,ciNPT 组在两次伤口评估和再次手术(P = 0.022)期间的伤口并发症显著减少(P < 0.0005)。亚组分析显示,ciNPT 对几乎所有检查的伤口愈合危险因素均有显著影响。ciNPT 可显著降低血管手术后切口并发症和再次手术的发生率。