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[个人偏好、经验、直觉以及外科流派主导着皮肤外科伤口引流的使用]

[Personal preference, experience, intuition and school of surgery dominate the use of wound drainage in dermatosurgery].

作者信息

Ruers Stephanie Sophia, Wagenpfeil Stefan, Gauglitz Gerd, Felcht Moritz, Wetzig Tino, Bechara Falk G, Koenen Wolfgang, Kunte Christian, Bruning Guido, Müller Cornelia S L

机构信息

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Campus Homburg, Homburg, Deutschland.

Institut für Medizinische Biometrie, Epidemiologie und Medizinische Informatik, Campus Homburg, Universität des Saarlandes, Homburg, Deutschland.

出版信息

Hautarzt. 2021 Feb;72(2):115-124. doi: 10.1007/s00105-020-04709-w.

Abstract

BACKGROUND

The use of drainage systems in dermatosurgery has so far been carried out without evidence-based data. The indications, complications and contraindications are traditionally passed on from surgeon to surgeon but have so far not been defined.

METHOD

An Internet-based survey was created and sent out to members of the German Society for Dermatosurgery (DGDC). The questions were on the general treatment approach in German language countries with reference to the use of wound drainage following dermatological operations as well as the utilization habits and experiences with drainage-associated complications.

RESULTS

Of the DGDC members contacted 12.73% completed the questionnaire. Drainages were predominantly used in the clinical environment and all drainage systems in question were used. The extent and complexity of the intervention were essential criteria when evaluating the indications. The use of drainages was dependent on the age of the participant and mostly carried out in patients where complications in the postoperative course were to be expected (e.g. obesity, nicotine use, diabetes).

CONCLUSION

In summary, the majority of the participants used wound drainages and mostly intuitively. Uniform and fixed evidence-based parameters for the use of wound drainages are lacking. In the assessment of the necessity for a wound drainage, an individually expressed need of safety seems to play a large role for some dermatosurgeons and an eminence-based action for others.

摘要

背景

迄今为止,皮肤外科中引流系统的使用缺乏循证数据。其适应证、并发症和禁忌证传统上是由外科医生口口相传,但至今尚未明确界定。

方法

设计了一项基于互联网的调查,并发送给德国皮肤外科学会(DGDC)的成员。问题涉及德语国家皮肤病手术后伤口引流的一般治疗方法,以及引流相关并发症的使用习惯和经验。

结果

在被联系的DGDC成员中,12.73%完成了问卷。引流主要用于临床环境,所有相关引流系统均有使用。评估适应证时,干预的范围和复杂性是关键标准。引流的使用取决于参与者的年龄,主要在预计术后会出现并发症的患者中进行(如肥胖、吸烟、糖尿病患者)。

结论

总之,大多数参与者使用伤口引流,且大多是凭直觉。缺乏统一且固定的伤口引流循证参数。在评估伤口引流的必要性时,对一些皮肤外科医生来说,个体化表达的安全需求似乎起很大作用,而对另一些医生来说,则是基于经验的做法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ae/7846541/cb36bfac6367/105_2020_4709_Fig1_HTML.jpg

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