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1. 应用封闭切口负压伤口疗法治疗肥胖症患者术后手术切口灌流模式的变化。

Changes of perfusion patterns of surgical wounds under application of closed incision negative pressure wound therapy in postbariatric patients1.

机构信息

Department of Plastic and Hand Surgery University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany.

Department of Plastic Surgery, Hand and Burn Surgery University Hospital of Aachen, RWTH University of Aachen, Aachen, Germany.

出版信息

Clin Hemorheol Microcirc. 2019;72(2):139-150. doi: 10.3233/CH-180450.

Abstract

BACKGROUND

Negative pressure wound therapy applied over closed incisions (ciNPT) has been shown to influence wound healing. Therefore, the aim of this study was to examine the short-term effects of ciNPT on skin perfusion patterns in postbariatric wounds.

METHODS

17 patients were included. Patients from the study group received a ciNPT dressing with a continuous negative pressure of - 125 mmHg for five days. Two intra- and two postoperative measurements were performed using both a combined laser Doppler spectrophotometry and an ICG angiography system to determine oxygen saturation (sO2), hemoglobin content (rHb) and perfusion patterns.

RESULTS

Three days postoperatively the sO2 was significantly higher in the study group compared to the control group and also compared to the end of the operation. Concerning the rHb, there was no statistical significant alteration in or between the groups, but a trend towards a correlated alteration of sO2 and rHb. ICG angiography showed an earlier and stronger enhancement of perfusion parameters in the study group.

CONCLUSION

CiNPT has a positive effect on oxygen saturation and tissue perfusion, which are both associated with the wound healing process. The use of ciNPT could therefore possibly reduce the risk of wound healing complications in this high-risk patient group.

摘要

背景

已证实,应用于闭合切口(ciNPT)的负压伤口治疗会影响伤口愈合。因此,本研究旨在检测 ciNPT 对减重手术后伤口皮肤灌注模式的短期影响。

方法

纳入 17 名患者。研究组患者接受持续负压 -125mmHg 的 ciNPT 敷料治疗 5 天。使用激光多普勒光谱光度法和 ICG 血管造影系统进行两次术中及两次术后测量,以确定氧饱和度(sO2)、血红蛋白含量(rHb)和灌注模式。

结果

术后 3 天,研究组的 sO2 明显高于对照组,也明显高于手术结束时。关于 rHb,组间或组内均无统计学显著改变,但 sO2 和 rHb 的改变呈相关趋势。ICG 血管造影显示研究组的灌注参数更早且更强。

结论

ciNPT 对氧饱和度和组织灌注有积极影响,这两者均与伤口愈合过程相关。因此,在这个高风险患者群体中,ciNPT 的应用可能降低伤口愈合并发症的风险。

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