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负压伤口疗法治疗外科伤口的安全性:17 项随机对照试验的更新荟萃分析。

The Safety of Negative-Pressure Wound Therapy on Surgical Wounds: An Updated Meta-analysis of 17 Randomized Controlled Trials.

机构信息

Dongmei Ge, BS, is Director, Central Sterile Supply Department, Shengli Oilfield Central Hospital, Dongying, Shandong, China. Acknowledgments: The author thanks Qiuju Ge and Jian Xu for their assistance with the study and valuable discussion. The author has disclosed no financial relationships related to this article. Submitted January 2, 2018; accepted in revised form May 16, 2018.

出版信息

Adv Skin Wound Care. 2018 Sep;31(9):421-428. doi: 10.1097/01.ASW.0000542530.71686.5c.

Abstract

OBJECTIVE

To assess whether negative-pressure wound therapy (NPWT) reduced complications such as wound infection, dehiscence, seroma/hematoma, skin necrosis/blistering, and bleeding compared with non-NPWT treatments.

METHODS

This meta-analysis involved randomized clinical trials of NPWT compared with non-NPWT on surgical wound healing. The main outcome was surgical site infections; secondary outcomes were dehiscence, seroma/hematoma, skin necrosis/blistering, bleeding, and reoperation.

MAIN RESULTS

Seventeen randomized controlled trials met the inclusion criteria, reporting on 928 NPWT and 930 non-NPWT patients. Compared with non-NPWT, NPWT was not associated with a significant reduction in wound infection (relative risk, 0.96; 95% confidence interval, 0.74-1.24). The reduction in wound dehiscence, seroma/hematoma, skin necrosis/blistering, and bleeding in the NPWT group was significant compared with that in the non-NPWT groups. Significant heterogeneity was observed in seroma/hematoma and skin necrosis/blistering between the NPWT and non-NPWT groups. No publication bias was observed.

CONCLUSIONS

Compared with non-NPWT, NPWT significantly reduced the rates of dehiscence, seroma/hematoma, skin necrosis\blistering, and bleeding, but not surgical site infections.

摘要

目的

评估负压伤口疗法(NPWT)是否能减少并发症,如伤口感染、裂开、血清肿/血肿、皮肤坏死/水疱和出血,与非 NPWT 治疗相比。

方法

本荟萃分析纳入了 NPWT 与非 NPWT 治疗手术伤口愈合的随机临床试验。主要结局是手术部位感染;次要结局是裂开、血清肿/血肿、皮肤坏死/水疱、出血和再次手术。

主要结果

17 项随机对照试验符合纳入标准,报告了 928 例 NPWT 和 930 例非 NPWT 患者。与非 NPWT 相比,NPWT 并未显著降低伤口感染的风险(相对风险,0.96;95%置信区间,0.74-1.24)。NPWT 组的伤口裂开、血清肿/血肿、皮肤坏死/水疱和出血的发生率显著低于非 NPWT 组。NPWT 组与非 NPWT 组在血清肿/血肿和皮肤坏死/水疱方面存在显著的异质性。未观察到发表偏倚。

结论

与非 NPWT 相比,NPWT 显著降低了裂开、血清肿/血肿、皮肤坏死/水疱和出血的发生率,但不能降低手术部位感染的发生率。

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