Lin Pao-Yuan, Liou Tz-Luen, Lin Ko-Chien, Hsieh Mu-Han, Chien Chih-Yen, Hsieh Ching-Hua
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung, Republic of China.
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung, Republic of China.
Laryngoscope. 2018 Nov;128(11):2478-2482. doi: 10.1002/lary.27169. Epub 2018 Sep 24.
This study aimed to assess the outcomes of administering negative-pressure wound therapy (NPWT) in patients immediately following free flap reconstruction after head and neck cancer surgery and radical neck lymph node dissection. The outcomes were compared with those of patients who received conventional wound care (CWC).
A retrospective analysis was performed for 58 patients with head and neck cancer who underwent free flap reconstruction after tumor ablation and radical neck dissection between February 1, 2016, and October 31, 2016. All reconstructions were performed by the same plastic surgeon. Charts were reviewed for patient demographics, comorbidities, cancer type, operation time, flap type, postoperative drainage volume, complication rates, length of hospital stay, and wound outcomes.
No significant difference was observed between patients receiving NPWT and CWC regarding operation time and drainage volume from the vacuum ball. After the application of NPWT, no patients experienced flap failure or developed a wound infection. Significantly fewer patients receiving NPWT developed complications (9.7% vs. 37.0%; P = 0.025) and developed infections (0.0% vs. 14.8%; P = 0.041) compared with those receiving CWC.
On the basis of fewer associated complications and infections, this study supports the immediate use of NPWT after free flap reconstruction in patients who have undergone head and neck cancer ablation and radical neck lymph node dissection.
本研究旨在评估头颈部癌手术及根治性颈淋巴结清扫术后立即对患者进行负压伤口治疗（NPWT）的效果，并将结果与接受传统伤口护理（CWC）的患者进行比较。
对2016年2月1日至2016年10月31日期间58例头颈部癌患者进行回顾性分析，这些患者在肿瘤切除及根治性颈清扫术后接受了游离皮瓣重建。所有重建手术均由同一位整形外科医生完成。查阅病历以获取患者的人口统计学信息、合并症、癌症类型、手术时间、皮瓣类型、术后引流量、并发症发生率、住院时间及伤口愈合情况。
接受NPWT和CWC的患者在手术时间和负压球引流量方面未观察到显著差异。应用NPWT后，无患者出现皮瓣坏死或伤口感染。与接受CWC的患者相比，接受NPWT的患者发生并发症（9.7% 对37.0%；P = 0.025）及感染（0.0% 对14.8%；P = 0.041）的患者明显减少。
基于较少的相关并发症和感染，本研究支持对头颈部癌切除及根治性颈淋巴结清扫术后接受游离皮瓣重建的患者立即使用NPWT。
4。《喉镜》，2478 - 2482，2018年。
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