Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, Texas.
Department of Surgery, Baylor College of Medicine, Houston, Texas.
Adv Wound Care (New Rochelle). 2020 May 1;9(5):211-218. doi: 10.1089/wound.2019.0999. Epub 2020 Mar 19.
Gastrostomy tubes (GTs) are one of the most common procedures in neonatal surgery, and their malfunction represents one of the most common complaints in the emergency room and clinic. Complications can occur in up to one-third of patients and include pain, peristomal leak, and infection, but can range in severity. We hypothesize that a preventative strategy employing a GT fixation dressing at the time of operation minimizes these postoperative complications in neonates. All patients less than 1 year of age who underwent laparoscopic GT placement by a single surgeon in the study period were reviewed. All tubes were secured in place on the external abdominal wall for 2 weeks postoperatively. Demographics and outcomes were evaluated. Fifty-three percent of our cohort were male, and 47% were premature. The most common indication for placement was failure to thrive (59%), and common comorbid conditions were characterized as neurologic (71%), and cardiac (59%). The dressing did not prevent hypertrophic granulation tissue formation, but no patient experienced surgical site infection or device-related pressure injury at 30 and 120 days postoperatively. No patient required reoperation or readmission. This simple, one-time, cost-effective fixation dressing has the potential to reduce some of the most common postoperative surgical issues in neonatal patients and can be applied in almost any health care setting. A dressing aimed at tube fixation and immobilization for the first two postoperative weeks averts some of the major complications of GT placement over a standard follow-up period as compared with the literature.
胃造口管（GT）是新生儿外科中最常见的手术之一，其故障是急诊室和诊所最常见的投诉之一。并发症可发生在多达三分之一的患者中，包括疼痛、造口周围漏液和感染，但严重程度不一。我们假设在手术时使用 GT 固定敷料可以最大限度地减少新生儿的这些术后并发症。 所有在研究期间由一位外科医生进行腹腔镜 GT 放置的年龄小于 1 岁的患者均接受了回顾性研究。所有管子在术后 2 周内均固定在腹部外部。评估了人口统计学和结果。 我们的队列中有 53%是男性，47%是早产儿。最常见的放置指征是生长不良（59%），常见的合并症表现为神经系统疾病（71%）和心脏疾病（59%）。这种敷料并不能预防肥厚性肉芽组织形成，但没有患者在术后 30 天和 120 天发生手术部位感染或与器械相关的压力性损伤。没有患者需要再次手术或再次入院。 这种简单、一次性、具有成本效益的固定敷料有可能减少新生儿患者中一些最常见的术后手术问题，几乎可以在任何医疗保健环境中使用。与文献相比，在标准随访期间，与固定和固定 GT 放置的第一个两周的敷料相比，这种敷料可以避免一些主要并发症。
