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妇科恶性肿瘤预防性切口负压伤口治疗。

Prophylactic incisional negative pressure wound therapy for gynaecologic malignancies.

机构信息

Department of Gynecology, Hospital Universitari Bellvitge, Barcelona, Spain.

Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Barcelona, Spain.

出版信息

Int Wound J. 2022 Feb;19(2):272-277. doi: 10.1111/iwj.13628. Epub 2021 Jul 16.

Abstract

Wound complications are an important cause of postoperative morbidity among patients with gynaecologic malignancies. We evaluated whether the placement of closed-incisional negative pressure therapy (ciNPT) at the time of laparotomy for gynaecologic cancer surgery reduced wound complication rates. A retrospective cohort study with primary wound closure performed by a gynaecologic oncologist was carried out. We evaluated two cohorts of patients who underwent surgery in 2017 with standard closure and patients who underwent surgery in 2019 with the placement of prophylactic ciNPT. Postoperative outcomes were examined. A total of 143 patients were included, 85 (59.4%) vs 58 (40.6%) with standard closure and ciNPT, respectively. The total complication rate in our sample was 38.71%. The rate of surgical complications in patients treated with ciNPT was 6.9% compared with 31.8% (P = .000) in patients treated with standard closure. In the analysis of complications, a significant reduction in infections (17.1%), seromas (15.4%), and wound dehiscence (17.1%) were observed when ciNPT was applied. The median hospital stay was 8 vs 6 days in the standard closure vs ciNPT groups (P = .048). The use of the prophylactic ciNPT following a laparotomy may decrease wound complications and hospital stays in oncological patients. ciNPT could be considered as part of clinical practice in patients at high risk of wound complications, such as patients with gynaecological malignancies.

摘要

切口并发症是妇科恶性肿瘤患者术后发病率的一个重要原因。我们评估了在妇科癌症手术的剖腹术中放置密闭式切口负压治疗(ciNPT)是否能降低切口并发症的发生率。这是一项回顾性队列研究,主要由妇科肿瘤学家进行一期切口闭合。我们评估了 2017 年接受标准缝合的两组患者和 2019 年接受预防性 ciNPT 缝合的两组患者。评估了术后结果。共纳入 143 例患者,其中 85 例(59.4%)和 58 例(40.6%)分别接受标准缝合和 ciNPT。我们样本的总并发症发生率为 38.71%。接受 ciNPT 治疗的患者中,手术并发症的发生率为 6.9%,而接受标准缝合的患者中,手术并发症的发生率为 31.8%(P=0.000)。在并发症分析中,与标准缝合组相比,ciNPT 组的感染(17.1%)、血清肿(15.4%)和切口裂开(17.1%)发生率显著降低。标准缝合组和 ciNPT 组的中位住院时间分别为 8 天和 6 天(P=0.048)。在剖腹术后预防性使用 ciNPT 可能会降低肿瘤患者的切口并发症发生率和住院时间。对于存在切口并发症高风险的患者(如妇科恶性肿瘤患者),ciNPT 可考虑作为临床实践的一部分。

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