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腹壁成形术中切口负压伤口治疗的比较试验

A Comparative Trial of Incisional Negative-Pressure Wound Therapy in Abdominoplasty.

作者信息

Abesamis Gerald M, Chopra Shiv, Vickery Karen, Deva Anand K

机构信息

Department of Plastic and Reconstructive Surgery, Macquarie University Hospital, Macquarie University, Sydney, Australia.

Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.

出版信息

Plast Reconstr Surg Glob Open. 2019 May 16;7(5):e2141. doi: 10.1097/GOX.0000000000002141. eCollection 2019 May.

Abstract

The risk for minor local complications for abdominoplasty remains high despite advances in strategies in recent years. The most common complication is the formation of seroma with reported rates ranging from 15% to 40%. The use of incisional negative-pressure wound therapy (iNPWT) on closed surgical sites has been shown to decrease the infection, dehiscence, and seroma rates. Thus, this article aims to determine whether an iNPWT dressing, Prevena Plus, is able to reduce postoperative drainage and seroma formation in patients who undergo abdominoplasty. Sixteen consecutive patients who underwent abdominoplasty by a single surgeon were dressed with standard dressings and iNPWT dressings. Total drain output, day of drain removal, and adverse events were compared between cohorts with a minimum follow-up of 6 months. The iNPWT group demonstrated a significantly less amount of fluid drainage with a mean total fluid output of 370 ± 275 ml compared to 1269 ± 436 ml mean total drainage from controls ( < 0.001). Time before removal of both drains was almost halved in the iNPWT group with an average of 5.3 ± 1.6 days, which was significantly less than the average time of 10.6 ± 2.9 days seen in control patients ( < 0.001). No observed adverse events were recorded in either group. Our findings show that iNPWT for a closed abdominoplasty incision decreases the rate of postoperative fluid accumulation and results in earlier drain removal.

摘要

尽管近年来手术策略有所进步,但腹部整形术后出现轻微局部并发症的风险仍然很高。最常见的并发症是血清肿形成,报告发生率在15%至40%之间。在闭合手术切口使用切口负压伤口治疗(iNPWT)已被证明可降低感染、切口裂开和血清肿发生率。因此,本文旨在确定一种iNPWT敷料Prevena Plus是否能够减少接受腹部整形手术患者的术后引流和血清肿形成。16例由同一位外科医生进行腹部整形手术的连续患者分别使用标准敷料和iNPWT敷料。对两组患者的总引流量、拔引流管天数及不良事件进行比较,随访时间至少6个月。iNPWT组的液体引流量显著减少,平均总液体引流量为370±275ml,而对照组的平均总引流量为1269±436ml(P<0.001)。iNPWT组拔除两根引流管的时间几乎减半,平均为5.3±1.6天,显著短于对照组患者的平均时间10.6±2.9天(P<0.001)。两组均未记录到观察到的不良事件。我们的研究结果表明,对于闭合性腹部整形手术切口,iNPWT可降低术后液体蓄积率并使引流管更早拔除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8822/6571337/96a62c9205a3/gox-7-e2141-g001.jpg

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