Orthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medical, Surgical and Life Sciences, Trieste University, Trieste (Italy).
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Acta Biomed. 2020 Dec 30;91(14-S):e2020006. doi: 10.23750/abm.v91i14-S.10784.
complications in surgical wound healing represent the main postoperative complication in ankle and distal tibia fractures. Whereas the use of Incisional Negative Pressure Wound Therapy (INPWT) is recognized to have a role in wound complications prevention in prosthetic surgery, literature about its use in trauma surgery is scarce. The aim of this study was to compare the effectiveness of INWPT with a conventional dressing in order to prevent surgical wound complications in ankle and distal tibia fractures.
The study population included patients over 65 years as well as patients under 65 years considered at risk for wound complications (smokers, obese, affected by diabetes), who underwent ORIF for bi/tri-malleolar ankle fractures or distal tibia (pilon) fractures. After surgery, patients were randomized to receive a conventional dressing or INPWT. Complications in surgical wound healing were classified in major (requiring surgical intervention) and minor complications.
65 patients were included in the study. The rate of minor and major complications between the two groups was not significantly different, although a positive trend towards a lower minor complications rate was noted in the INPWT group (12.6% vs 34.7%). No complications or complaints were reported for the INPWT device.
INPWT proved to be safe, well-tolerated and showed promising results in preventing surgical wound complications in ankle and distal tibia fractures.
手术切口愈合并发症是踝关节和胫骨远端骨折术后的主要并发症。虽然切口负压伤口治疗（INPWT）在预防假体手术中的伤口并发症方面已得到认可，但在创伤外科中使用 INPWT 的文献却很少。本研究旨在比较 INWPT 与常规敷料在预防踝关节和胫骨远端骨折手术切口并发症方面的效果。
研究人群包括 65 岁以上的患者以及有伤口并发症风险的 65 岁以下患者（吸烟者、肥胖者、糖尿病患者），他们接受了踝关节双/三踝骨折或胫骨远端（PILON）骨折的切开复位内固定术。手术后，患者被随机分配接受常规敷料或 INPWT。将手术切口愈合并发症分为主要（需要手术干预）和次要并发症。
本研究共纳入 65 例患者。两组患者的小、大并发症发生率无显著差异，但 INPWT 组小并发症发生率较低（12.6%比 34.7%），呈积极趋势。INPWT 装置未出现任何并发症或不良事件。
INPWT 安全、耐受良好，在预防踝关节和胫骨远端骨折手术切口并发症方面显示出良好的效果。
