Department of Surgery, University of California San Francisco-East Bay, Oakland.
Stanford University School of Medicine, CA.
Perm J. 2020;24. doi: 10.7812/TPP/19.173. Epub 2020 Feb 7.
Abdominoperineal resection is associated with a high rate of wound complications. A high degree of wound tension, a common contributor to wound breakdown and complications, may be mitigated by incisional negative-pressure wound therapy (NPWT). Although NPWT has been shown to reduce complications associated with open and complex wounds, there is a paucity of data regarding its prophylactic use for incisional wounds.
To determine the effect of NPWT use on surgical wound complications of abdominoperineal resection for malignancy.
We performed a systematic review by querying the PubMed database for studies from 1990 to 2019 and included English-language studies that used incisional NPWT for closed wounds from abdominoperineal resection in malignancy cases.
Five studies with a total of 76 patients were included. Their findings showed reduced rates of surgical site complications with the use of incisional NPWT. Another 2 studies describing the use of prophylactic NPWT to expedite secondary closure of the surgical wound followed by incisional wound therapy were separately categorized and included 8 patients, none of whom experienced wound wound complications.
Additional, prospective research is needed to confirm the benefit of prophylactic incisional NPWT.
腹会阴联合切除术（APR）相关的切口并发症发生率较高。切口张力较大是导致切口愈合不良和并发症的常见原因，而切口负压伤口治疗（NPWT）可能会减轻这种张力。尽管 NPWT 已被证明可降低与开放性和复杂性伤口相关的并发症，但关于其在预防性切口应用的数据却很少。
确定 NPWT 对恶性肿瘤 APR 切口并发症的影响。
我们通过查询 1990 年至 2019 年的 PubMed 数据库进行系统综述，并纳入了使用切口 NPWT 治疗恶性肿瘤 APR 闭合性切口的英文研究。
共纳入 5 项研究，总计 76 例患者。研究结果显示，使用切口 NPWT 可降低手术部位并发症的发生率。另有 2 项研究描述了预防性 NPWT 的使用，以加速手术切口的二期闭合，然后进行切口伤口治疗，这两项研究分别单独分类，共纳入 8 例患者，均未发生切口并发症。
需要进一步的前瞻性研究来证实预防性切口 NPWT 的益处。
