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负压伤口疗法与癌症手术伤口常规护理的比较:观察性研究和随机对照试验的荟萃分析。

Negative pressure wound therapy versus conventional wound care in cancer surgical wounds: A meta-analysis of observational studies and randomised controlled trials.

机构信息

Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, Indonesia.

出版信息

Int Wound J. 2022 Oct;19(6):1578-1593. doi: 10.1111/iwj.13756. Epub 2022 Feb 2.

DOI:10.1111/iwj.13756
PMID:35112467
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9493220/
Abstract

The application of negative pressure wound therapy (NPWT) in cancer surgical wounds is still controversial, despite its promising usage, because of the risks of increased tumorigenesis and metastasis. This study aimed to review the risks and benefits of NPWT in surgical wounds with the underlying malignant disease compared with conventional wound care (CWC). The first outcome was wound complications, divided into surgical site infection (SSI), seroma, hematoma, and wound dehiscence. The secondary outcome was hospital readmission. We performed a separate meta-analysis of observational studies and randomised controlled trials (RCTs) with CI 95%. Thirteen observational studies with 1923 patients and seven RCTs with 1091 patients were included. NPWT group showed significant decrease in the risk of SSI (RR = 0.45) and seroma (RR = 0.61) in observational studies with P value <0.05, as well as RCTs but were not significant (RR = 0.88 and RR = 0.68). Wound dehiscence (RR = 0.74 and RR = 1.15) and hospital readmission (RR = 0.90 and RR = 0.62) showed lower risks in NPWT group but were not significant. Hematoma (RR = 1.08 and RR = 0.87) showed no significant difference. NPWT is not contraindicated in cancer surgical wounds and can be considered a beneficial palliative treatment to promote wound healing.

摘要

负压伤口疗法(NPWT)在癌症手术伤口中的应用仍然存在争议,尽管其具有广阔的应用前景,但由于其增加肿瘤发生和转移的风险,NPWT 在癌症手术伤口中的应用仍存在争议。本研究旨在回顾与常规伤口护理(CWC)相比,NPWT 在伴恶性疾病的手术伤口中的风险和益处。主要结果是伤口并发症,分为手术部位感染(SSI)、血清肿、血肿和伤口裂开。次要结果是住院再入院。我们对观察性研究和随机对照试验(RCT)进行了单独的荟萃分析,置信区间为 95%。纳入了 13 项包含 1923 例患者的观察性研究和 7 项包含 1091 例患者的 RCT。NPWT 组在观察性研究中,SSI(RR=0.45)和血清肿(RR=0.61)的风险显著降低,P 值<0.05,RCT 也有类似的结果但无统计学意义(RR=0.88 和 RR=0.68)。伤口裂开(RR=0.74 和 RR=1.15)和住院再入院(RR=0.90 和 RR=0.62)的风险较低,但无统计学意义。血肿(RR=1.08 和 RR=0.87)无显著差异。NPWT 并非癌症手术伤口的禁忌症,可被视为促进伤口愈合的有益姑息治疗。

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