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Integra 联合负压伤口疗法的临床应用经验:一种处理骨或肌腱外露伤口的替代方法。

Clinical experience of the use of Integra in combination with negative pressure wound therapy: an alternative method for the management of wounds with exposed bone or tendon.

机构信息

Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital of AnHui Medical University, Hefei, China.

出版信息

J Plast Surg Hand Surg. 2021 Feb;55(1):1-5. doi: 10.1080/2000656X.2020.1781140. Epub 2021 Jan 12.

Abstract

The use of Integra has attracted great interest in the treatment of wounds with exposed bone or tendon, which may lead to associated morbidities. However, the use of Integra alone results in poor wound outcomes. We conducted a randomized clinical study to evaluate the combined effects of Integra and negative pressure wound therapy (NPWT). Thirty-six patients with wounds with exposed bone or tendons were treated with Integra alone and with a combination of Integra and NPWT ( = 18 respectively). Negative pressure (125 mm Hg) was applied intermittently till Integra was revascularized. The take rate of Integra and time taken from Integra coverage to skin transplantation was recorded for each case. The average take rate of Integra in the conventional treatment group (Integra with partial packing compression dressings) was lower than that for the new treatment group (Integra with NPWT) ( < 0.001, 95% CI: 6.44-0.20). The mean time period from Integra coverage to skin transplantation was longer for the conventional treatment group than for the new treatment group ( < 0.001, 95% CI: -13.18 to -11.24). The application of NPWT could potentially increase the take rate of Integra and shorten the duration of hospital stay. The use of Integra with NPWT could be a treatment option for wounds with exposed bone or tendon.

摘要

使用 Integra 在治疗暴露骨或肌腱的伤口方面引起了极大的兴趣,这可能导致相关的发病率。然而,单独使用 Integra 会导致伤口愈合不良。我们进行了一项随机临床试验,以评估 Integra 和负压伤口治疗(NPWT)联合治疗的效果。36 例有暴露骨或肌腱的伤口患者分别接受 Integra 单独治疗和 Integra 联合 NPWT 治疗( = 18 例)。间歇性施加负压(125mmHg),直到 Integra 血管化。记录每个病例 Integra 的贴合率和从 Integra 覆盖到皮肤移植的时间。常规治疗组(使用 Integra 部分填充加压敷料)的 Integra 贴合率低于新治疗组(使用 NPWT 的 Integra)( < 0.001,95%CI:6.44-0.20)。常规治疗组从 Integra 覆盖到皮肤移植的平均时间比新治疗组长( < 0.001,95%CI:-13.18 至-11.24)。NPWT 的应用可能会增加 Integra 的贴合率并缩短住院时间。使用 Integra 联合 NPWT 可能是治疗暴露骨或肌腱的伤口的一种选择。

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