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一项关于负压伤口治疗对骨科创伤手术闭合切口影响的系统评价和荟萃分析,与传统敷料相比。

A systemic review and a meta-analysis on the influences of closed incisions in orthopaedic trauma surgery by negative pressure wound treatment compared with conventional dressings.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China.

出版信息

Int Wound J. 2023 Jan;20(1):46-54. doi: 10.1111/iwj.13835. Epub 2022 May 10.

Abstract

We performed a meta-analysis to evaluate the influences of closed incisions in orthopaedic trauma surgery (OTS) by negative pressure wound treatment (NPWT) compared with conventional dressings. A systematic literature search up to March 2022 was done and 14 studies included 3935 subjects with OTS at the start of the study; 2023 of them used NPWT and 1912 were conventional dressings. They were reporting relationships between the influences of closed incisions in OTS by NPWT compared with conventional dressings. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the influences of closed incisions in OTS by NPWT compared with conventional dressings using the dichotomous methods with a random or fixed-effect model. NPWT had significantly lower deep surgical site infections (SSIs) (OR, 0.65; 95% CI, 0.48-0.87, P = .004), superficial SSIs (OR, 0.34; 95% CI, 0.19-0.61, P < .001), and wound dehiscence (OR, 0.41; 95% CI, 0.21-0.80, P = .009) compared with conventional dressings in subjects with closed incisions in OTS. NPWT showed a beneficial effect on deep SSIs, superficial SSIs, and wound dehiscence compared with conventional dressings in subjects with closed incisions in OTS. Further studies are required to validate these findings.

摘要

我们进行了一项荟萃分析,以评估负压伤口治疗(NPWT)闭合切口在骨科创伤手术(OTS)中的影响,与传统敷料相比。系统文献检索截至 2022 年 3 月,共纳入 14 项研究,共有 3935 例 OTS 患者在研究开始时接受治疗;其中 2023 例使用 NPWT,1912 例使用传统敷料。他们报告了 NPWT 闭合切口与传统敷料对 OTS 的影响之间的关系。我们使用二项式方法计算了比值比(OR)和 95%置信区间(CI),以评估 NPWT 闭合切口与传统敷料对 OTS 的影响,使用随机或固定效应模型。NPWT 显著降低了深部手术部位感染(SSI)(OR,0.65;95%CI,0.48-0.87,P=0.004)、浅部 SSI(OR,0.34;95%CI,0.19-0.61,P<0.001)和伤口裂开(OR,0.41;95%CI,0.21-0.80,P=0.009),与 OTS 闭合切口患者使用传统敷料相比。NPWT 与传统敷料相比,对 OTS 闭合切口患者的深部 SSI、浅部 SSI 和伤口裂开有有益影响。需要进一步的研究来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7651/9797922/41b6e727a86b/IWJ-20-46-g002.jpg

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