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负压伤口治疗(NPWT)终结手术部位感染:一例报告

Ending surgical site infection by negative pressure wound therapy (NPWT): A case report.

作者信息

Arad Mansour, Goli Rasoul, Ebrahimzade Mazhar, Lorzini Mohammad, Abdali Mahnaz, Sepehrnia Nazila

机构信息

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Urmia, Iran.

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Urmia, Iran.

出版信息

Int J Surg Case Rep. 2022 May;94:107080. doi: 10.1016/j.ijscr.2022.107080. Epub 2022 Apr 12.

Abstract

INTRODUCTION AND IMPORTANCE

Hundreds of millions of people may go through surgery every year worldwide. Surgical site infection (SSI) is one of the most common complications of the surgery. SSI increases the duration of treatment, delays wound healing, increases the use of antibiotics, and in severe cases, causes patient death and imposes high costs on the patient and the health care system.

CASE PRESENTATION

The present case report is a 45-year-old man with a history of 8-years type 2 diabetes who underwent surgery for a pilonidal cyst. Despite routine dressing changes (cleansing the wound with saline and applying sterile gauze) twice a day and intravenous (IV) antibiotic therapy, no improvement was observed and the wound became infected. The patient was referred to our wound care team. NPWT (applying a pressure of 125 mm Hg intermittently) was performed 4 times a day for one week. Also, after each session until the beginning of the next session, the patient's wound was bandaged. The patient's wound healed completely after about 2 months.

CLINICAL DISCUSSION

Patients with diabetes mellitus will have difficulty in wound healing due to microvascular changes. Thus, efficient therapeutic methods such as surgical debridement, maggot therapy, and NPWT are necessary for management of surgical site infection.

CONCLUSION

This case report was showed that NPWT is an affordable and highly efficacious treatment method for management of SSI in patients with diabetes mellitus. Therefore, it is suggested that wound care teams may use NPWT to treat SSIs.

摘要

引言与重要性

全球每年可能有数亿人接受手术。手术部位感染(SSI)是手术最常见的并发症之一。SSI会延长治疗时间、延迟伤口愈合、增加抗生素的使用,严重时会导致患者死亡,并给患者和医疗保健系统带来高昂成本。

病例介绍

本病例报告的是一名45岁男性,有8年2型糖尿病病史,因藏毛窦接受手术。尽管每天进行两次常规换药(用生理盐水清洁伤口并敷上无菌纱布)以及静脉注射抗生素治疗,但未见改善,伤口发生了感染。该患者被转诊至我们的伤口护理团队。采用负压伤口治疗(NPWT,间歇性施加125毫米汞柱的压力),每天进行4次,持续一周。此外,在每次治疗后直至下一次治疗开始前,对患者的伤口进行包扎。约2个月后患者伤口完全愈合。

临床讨论

糖尿病患者由于微血管变化,伤口愈合会有困难。因此,有效的治疗方法如手术清创、蛆虫疗法和NPWT对于手术部位感染的管理是必要的。

结论

本病例报告表明,NPWT是治疗糖尿病患者SSI的一种经济且高效的治疗方法。因此,建议伤口护理团队可使用NPWT治疗SSIs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecad/9171532/a8d4ef5e11e8/gr1.jpg

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