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负压伤口疗法在急诊科预防蛇咬伤后皮肤坏死的应用:一项回顾性队列研究。

Negative pressure wound therapy for skin necrosis prevention after snakebite in the emergency department: A retrospective cohort study.

机构信息

Department of Emergency Medicine, Chungnam National University Hospital, 282.

Department of Emergency Medicine, College of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon.

出版信息

Medicine (Baltimore). 2021 Jan 22;100(3):e24290. doi: 10.1097/MD.0000000000024290.

Abstract

This retrospective cohort study aimed to compare the effectiveness of conventional treatment and ultra-early application of negative pressure wound therapy (NPWT) in patients with snakebites.Patients who visited the emergency department within 24 hours after a snakebite were assigned to the non- NPWT or NPWT group. Swelling resolution time and rates of necrosis, infection, and operations were compared between the 2 groups. The Stony Brook Scar Evaluation Scale was used to measure short- and long-term wound healing results.Among the included 61 patients, the swelling resolution time was significantly shorter in the NPWT group than in non- NPWT group (P = .010). The NPWT group showed lower necrosis (4.3% versus 36.8%; P = .003) and infection (13.2% and 4.3%; P = .258) rates than the non- NPWT group. The median Stony Brook Scar Evaluation Scale scores were higher in the NPWT group than in the non- NPWT group (P< .001).These findings suggest that ultra-early application of NPWT reduces edema, promotes wound healing, and prevents necrosis in patients with snakebites.

摘要

本回顾性队列研究旨在比较传统治疗与负压伤口治疗(NPWT)在蛇咬伤患者中的疗效。将在蛇咬伤后 24 小时内就诊的患者分为非 NPWT 组或 NPWT 组。比较两组患者的肿胀消退时间、坏死、感染和手术发生率。采用 Stony Brook 瘢痕评估量表评估短期和长期的伤口愈合效果。在纳入的 61 例患者中,NPWT 组的肿胀消退时间明显短于非 NPWT 组(P=0.010)。NPWT 组的坏死(4.3%比 36.8%;P=0.003)和感染(13.2%比 4.3%;P=0.258)发生率低于非 NPWT 组。NPWT 组的 Stony Brook 瘢痕评估量表评分中位数高于非 NPWT 组(P<0.001)。这些发现表明,超早期应用 NPWT 可减轻蛇咬伤患者的水肿,促进伤口愈合,预防坏死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee37/7837876/cbafacd836b5/medi-100-e24290-g001.jpg

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