Kanapathy Muholan, Mantelakis Angelos, Khan Natasha, Younis Ibby, Mosahebi Afshin
Division of Surgery and Interventional Science, University College London, London, UK.
Department of Plastic and Reconstructive Surgery, Royal Free NHS Foundation Trust Hospital, London, UK.
Int Wound J. 2020 Dec;17(6):1948-1959. doi: 10.1111/iwj.13487. Epub 2020 Oct 5.
This study evaluates the current clinical evidence of Negative Pressure Wound Therapy with Instillation and dwell time (NPWTi-d) to establish its clinical application and efficacy. MEDLINE, EMBASE, and CENTRAL databases were searched from 1946 to July 2019 for studies reporting clinical outcomes on wounds treated with NPWTi-d. The primary outcome was proportion of wounds with complete healing. The secondary outcomes were mean time for healing, NPWTi-d settings, cost, length of stay, and adverse events. Thirteen articles were included with a total of 624 wounds in 542 patients involving wounds of various aetiology. The pooled proportion of wound that achieved complete healing was 93.65% (95%CI: 84.02-99.04). Normal saline was the most commonly used instillation solution with the mean dwell time of 14.23 minutes (95%CI: 10.88-17.59) and instillation cycle every 4.17 ± 2.32 hourly. The mean therapy duration was 10.69 days (95%CI: 10.46-10.91) with daily cost of $194.80. The mean hospital stay was 18.1 days (95%CI: 17.20-19.00). There were no severe adverse effects reported. NPWTi-d is an adjuntive therapy to aid complete healing of the vast majority of wounds. However, the current data are limited by the lack of level 1 evidence.
本研究评估了间歇性负压封闭引流技术（NPWTi-d）的当前临床证据，以确定其临床应用及疗效。检索了MEDLINE、EMBASE和CENTRAL数据库1946年至2019年7月间报告NPWTi-d治疗伤口临床结局的研究。主要结局是伤口完全愈合的比例。次要结局包括愈合的平均时间、NPWTi-d设置、成本、住院时间和不良事件。纳入13篇文章，共涉及542例患者的624处伤口，伤口病因各异。伤口实现完全愈合的合并比例为93.65%（95%CI：84.02-99.04）。生理盐水是最常用的灌洗溶液，平均保留时间为14.23分钟（95%CI：10.88-17.59），每4.17±2.32小时进行一次灌洗循环。平均治疗持续时间为10.69天（95%CI：10.46-10.91），每日成本为194.80美元。平均住院时间为18.1天（95%CI：17.20-19.00）。未报告严重不良反应。NPWTi-d是一种辅助治疗方法，有助于绝大多数伤口的完全愈合。然而，目前的数据因缺乏一级证据而受到限制。
