Hsu Kuo-Feng, Kao Li-Ting, Chu Pei-Yi, Chen Chun-Yu, Chou Yu-Yu, Huang Dun-Wei, Liu Ting-Hsuan, Tsai Sheng-Lin, Wu Chien-Wei, Hou Chih-Chun, Wang Chih-Hsin, Dai Niann-Tzyy, Chen Shyi-Gen, Tzeng Yuan-Sheng
Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan.
Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan.
J Pers Med. 2022 Jan 29;12(2):182. doi: 10.3390/jpm12020182.
In this study, we aimed to analyze the clinical efficacy of closed-incision negative pressure wound therapy (CiNPWT) when combined with primary closure (PC) in a patient with pressure ulcers, based on one single surgeon's experience at our medical center.
We retrospectively reviewed the data of patients with stage III or IV pressure ulcers who underwent reconstruction surgery. Patient characteristics, including age, sex, cause and location of defect, comorbidities, lesion size, wound reconstruction methods, operation time, debridement times, application of CiNPWT to reconstructed wounds, duration of hospital stay, and wound complications were analyzed.
Operation time (38.16 ± 14.02 vs. 84.73 ± 48.55 min) and duration of hospitalization (36.78 ± 26.92 vs. 56.70 ± 58.43 days) were shorter in the PC + CiNPWT group than in the traditional group. The frequency of debridement (2.13 ± 0.98 vs. 2.76 ± 2.20 times) was also lower in the PC + CiNPWT group than in the traditional group. The average reconstructed wound size did not significantly differ between the groups (63.47 ± 42.70 vs. 62.85 ± 49.94 cm), and there were no significant differences in wound healing (81.25% vs. 75.38%), minor complications (18.75% vs. 21.54%), major complications (0% vs. 3.85%), or mortality (6.25% vs. 10.00%) between the groups.
Our findings indicate that PC combined with CiNPWT represents an alternative reconstruction option for patients with pressure ulcers, especially in those for whom prolonged anesthesia is unsuitable.
在本研究中,我们旨在基于我们医疗中心一位外科医生的经验,分析闭合切口负压伤口治疗(CiNPWT)联合一期缝合(PC)治疗压疮患者的临床疗效。
我们回顾性分析了接受重建手术的III期或IV期压疮患者的数据。分析了患者特征,包括年龄、性别、缺损原因和部位、合并症、病变大小、伤口重建方法、手术时间、清创次数、CiNPWT在重建伤口上的应用、住院时间和伤口并发症。
PC + CiNPWT组的手术时间(38.16 ± 14.02 vs. 84.73 ± 48.55分钟)和住院时间(36.78 ± 26.92 vs. 56.70 ± 58.43天)均短于传统组。PC + CiNPWT组的清创频率(2.13 ± 0.98 vs. 2.76 ± 2.20次)也低于传统组。两组间平均重建伤口大小无显著差异(63.47 ± 42.70 vs. 62.85 ± 49.94平方厘米),两组间伤口愈合情况(81.25% vs. 75.38%)、轻微并发症(18.75% vs. 21.54%)、严重并发症(0% vs. 3.85%)或死亡率(6.25% vs. 10.00%)均无显著差异。
我们的研究结果表明,PC联合CiNPWT是压疮患者的一种替代重建选择,特别是对于那些不适合长时间麻醉的患者。