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负压伤口疗法在外科伤口应用的肿瘤学可行性:一项荟萃分析。

Oncologic feasibility for negative pressure wound therapy application in surgical wounds: A meta-analysis.

机构信息

Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan.

Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.

出版信息

Int Wound J. 2022 Mar;19(3):573-582. doi: 10.1111/iwj.13654. Epub 2021 Jun 29.

Abstract

Negative pressure wound therapy (NPWT) decreases postoperative complications of various surgeries. However, the use of NPWT for oncological surgical wounds remains controversial. To evaluate the association of NPWT with oncologic recurrence in surgical wounds without residual malignancy, we analysed studies that compared NPWT with conventional non-pressure dressings for cancer surgical wounds without residual tumour by August 12, 2020. We compared tumour recurrence rates and postoperative complications between the two procedures. The six studies included 118 patients who received NPWT, and 149 patients who received conventional non-pressure wound care. The overall quality of the included studies was high based on the Newcastle-Ottawa scale score of 7.5. Tumour recurrence after NPWT was not significantly different compared with conventional non-negative pressure wound care (9.3% versus 11.4%, P = 0.40). There was no significant heterogeneity between the studies (I  = 3%). Although NTWT was associated with a lower complication rate compared with the control group, the result was non-significant (P = 0.15). Application of NPWT in oncologic resection wounds without residual malignancy revealed no difference in local recurrence and may reduce the risk of postoperative complications compared with conventional non-negative pressure dressings. NPWT can be considered an alternative method for reconstruction in challenging cases.

摘要

负压伤口疗法(NPWT)可降低各种手术的术后并发症。然而,NPWT 在肿瘤外科伤口中的应用仍存在争议。为了评估 NPWT 与无残留恶性肿瘤的外科伤口中肿瘤复发的相关性,我们分析了截至 2020 年 8 月 12 日比较 NPWT 与常规非压力敷料用于无肿瘤残留的癌症外科伤口的研究。我们比较了两种方法的肿瘤复发率和术后并发症。这六项研究共纳入了 118 名接受 NPWT 的患者和 149 名接受常规非压力伤口护理的患者。基于纽卡斯尔-渥太华量表评分 7.5,纳入研究的整体质量较高。NPWT 后肿瘤复发与常规非负压伤口护理相比无显著差异(9.3%比 11.4%,P=0.40)。研究之间无显著异质性(I²=3%)。虽然 NPWT 与对照组相比,并发症发生率较低,但差异无统计学意义(P=0.15)。在无残留恶性肿瘤的肿瘤切除伤口中应用 NPWT 并未显示局部复发的差异,并且与常规非负压敷料相比可能降低术后并发症的风险。NPWT 可被视为在具有挑战性的病例中重建的一种替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/362a/8874112/7916ac555c01/IWJ-19-573-g002.jpg

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