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经乳晕入路乳房重建术后应用切口负压伤口治疗减少并发症发生率和血清肿形成的效果。

Usefulness of Incisional Negative Pressure Wound Therapy for Decreasing Wound Complication Rates and Seroma Formation Following Prepectoral Breast Reconstruction.

机构信息

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.

出版信息

Aesthetic Plast Surg. 2022 Apr;46(2):633-641. doi: 10.1007/s00266-020-02115-0. Epub 2021 Jan 20.

Abstract

BACKGROUND

Seroma is a common complication in prepectoral breast reconstruction. PICO dressing, a type of incisional negative pressure wound therapy (iNPWT), was used to reduce complications postoperatively.

METHODS

This study was a retrospective cohort study that included patients who underwent prepectoral breast reconstruction between February 2017 and July 2019. There were two groups: one that received PICO dressing and a control group. The frequencies of overall complications, major seromas, and reoperations were analyzed. The durations and total amounts of seromas were also analyzed.

RESULT

Sixty patients were included in this study (PICO : 37 and non-PICO patients: 23). The overall incidence of complications, major seromas, and frequency of reoperations were lower in the PICO group compared to the non-PICO group (18.9% vs. 52.2%, p = 0.007; 16.2% vs. 43.5%, p = 0.020; 2.7% vs. 26.1%, p = 0.006, respectively). Univariate analysis was used to analyze the risk factors for complications due to the application of PICO dressing and showed statistically significant results for any complication. When univariate analysis was performed on risk factors for seroma, the duration of seroma showed statistical significance in association with PICO dressing status and mastectomy volume. The total number of patients who developed seroma was statistically correlated with age, PICO dressing status, and mastectomy volume.

CONCLUSIONS

PICO dressing after prepectoral breast reconstruction could be a useful tool for reducing the frequency of complications and major seroma, as well as the duration and total incidences of seroma.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

血清肿是胸肌前置乳房重建的常见并发症。PICO 敷料是一种切口负压伤口治疗(iNPWT),用于减少术后并发症。

方法

这是一项回顾性队列研究,纳入 2017 年 2 月至 2019 年 7 月期间接受胸肌前置乳房重建的患者。分为 PICO 敷料组和对照组。分析了总体并发症、大量血清肿和再手术的频率。还分析了血清肿的持续时间和总量。

结果

本研究共纳入 60 例患者(PICO 组:37 例,非 PICO 组:23 例)。与非 PICO 组相比,PICO 组的总体并发症、大量血清肿和再手术的发生率较低(18.9% vs. 52.2%,p = 0.007;16.2% vs. 43.5%,p = 0.020;2.7% vs. 26.1%,p = 0.006)。单因素分析用于分析 PICO 敷料应用并发症的危险因素,结果显示任何并发症的风险因素均有统计学意义。当对血清肿的危险因素进行单因素分析时,血清肿持续时间与 PICO 敷料状态和乳房切除术体积呈统计学显著相关。发生血清肿的患者总数与年龄、PICO 敷料状态和乳房切除术体积呈统计学相关。

结论

胸肌前置乳房重建后使用 PICO 敷料可能是减少并发症和大量血清肿、以及血清肿持续时间和总发生率的有用工具。

证据水平 IV:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

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