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负压伤口敷料可降低婴儿腹部闭合手术后手术部位感染率:初步报告

Negative Pressure Wound Dressing Reduces Surgical Site Infections in Infants after Closed Abdominal Procedures: A Preliminary Report.

作者信息

Zoeller Christoph, Yoshizawa Emi, Sethi Mohammad V, Ure Benno M, Kuebler Joachim F

机构信息

Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.

出版信息

Eur J Pediatr Surg. 2019 Aug;29(4):384-387. doi: 10.1055/s-0038-1660448. Epub 2018 Jun 19.

Abstract

INTRODUCTION

Negative pressure wound therapy (NPWT) is a novel tool to reduce surgical site infections (SSIs). Although SSIs are a common source of morbidity in infants undergoing laparotomy, the cost of the available NPWT devices has restricted its use to adult high-risk patients. We developed a low-cost method of NPWT in infants and analyzed its impact on the incidence of SSIs in infant patients.

MATERIALS AND METHODS

A consecutive series of infants (age ≤ 12 months) who underwent a clean-contaminated, contaminated, or dirty abdominal procedure via laparotomy from 08/2015 to 12/2016 were included. The choice of the applied dressing, either NPWT or standard surgical dressing (SSD), was made at the surgeon's discretion. SSIs were documented prospectively. The Horan definition and the Clavien-Dindo classification were used. The cost of material was calculated for both groups.

RESULTS

Ninety-three consecutive patients were included (65 SSD and 28 NPWT). SSI occurred in 10 patients in the SSD group, Grade I in 7 and Grade II in 3 (Clavien-Dindo classification). No SSI occurred in patients with NPWT ( < 0.05). The cost of an SSD was less than 1 €, and the cost of a NPWT was less than 10 €.

CONCLUSION

The routine use of this modified vacuum wound dressing may be an efficient and affordable technique to decrease SSIs in infants who underwent contaminated abdominal operations.

摘要

引言

负压伤口治疗(NPWT)是一种减少手术部位感染(SSI)的新型工具。虽然SSI是接受剖腹手术的婴儿发病的常见原因,但现有NPWT设备的成本限制了其仅用于成人高危患者。我们开发了一种针对婴儿的低成本NPWT方法,并分析了其对婴儿患者SSI发生率的影响。

材料与方法

纳入2015年8月至2016年12月期间通过剖腹手术接受清洁-污染、污染或脏污腹部手术的连续系列婴儿(年龄≤12个月)。应用敷料的选择,即NPWT或标准手术敷料(SSD),由外科医生自行决定。前瞻性记录SSI。采用霍兰定义和克莱文-迪诺分类。计算两组的材料成本。

结果

纳入93例连续患者(65例使用SSD,28例使用NPWT)。SSD组有10例发生SSI,根据克莱文-迪诺分类,I级7例,II级3例。NPWT患者未发生SSI(P<0.05)。SSD成本低于1欧元,NPWT成本低于10欧元。

结论

对于接受污染性腹部手术的婴儿,常规使用这种改良的真空伤口敷料可能是一种有效且经济实惠的减少SSI的技术。

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