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负压伤口疗法可降低肥胖患者全膝关节置换术后伤口裂开和手术部位感染的发生率。

Negative pressure wound therapy reduces the incidence of postoperative wound dehiscence and surgical site infections after total knee arthroplasty in patients with obesity.

机构信息

The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.

出版信息

Medicine (Baltimore). 2022 Jul 8;101(27):e29641. doi: 10.1097/MD.0000000000029641.

Abstract

Obesity is a risk factor for total knee arthroplasty (TKA). Wound dehiscence and surgical site infections (SSIs) are the main complications of TKA in patients with obesity. They can profoundly affect patients because they often require readmission, additional surgical interventions, lengthy intravenous antibiotic administration, and delayed rehabilitation. Negative pressure wound therapy (NPWT) exposes the wound site to negative pressure, resulting in the improvement of blood supply, removal of excess fluid, and stimulation of cellular proliferation of granulation tissue. This study aims to assess the incidence of wound dehiscence and SSIs in patients with obesity undergoing TKA after the routine use of NPWT. This sduty enrolled adult patients with obesity who underwent TKA within 8 years. A total of 360 adult patients with obesity (NPWT: 150, non-NPWT: 210) underwent TKA, and the baseline characteristics were similar between the 2 groups. Compared with the non-NPWT group, the NPWT group had a 50% lower incidence of wound dehiscence (3.33% vs 9.52%; P < .05) and a significantly lower incidence of SSIs (11.33% vs 25.24%; P < .05), including prosthetic joint infection (4.0% vs 10.0%; P < .05) and superficial wound infection (7.33% vs 15.24%; P < .05). In addition, the NPWT group had a lower need to return to the operating room for new interventions for any reason (2.67% vs 9.05%; P = .0107) than the non-NPWT group. Conventional incision NPWT can significantly reduce the incidence of wound dehiscence and SSIs in patients with obesity after TKA.

摘要

肥胖是全膝关节置换术(TKA)的一个风险因素。对于肥胖患者,TKA 的主要并发症是伤口裂开和手术部位感染(SSI)。这些并发症会严重影响患者,因为他们通常需要再次住院、接受额外的手术干预、长时间静脉使用抗生素以及康复延迟。负压伤口治疗(NPWT)会使伤口部位承受负压,从而改善血液供应、清除多余液体并刺激肉芽组织的细胞增殖。本研究旨在评估常规使用 NPWT 后肥胖患者接受 TKA 后伤口裂开和 SSI 的发生率。这项研究纳入了 8 年内接受 TKA 的肥胖成年患者。共有 360 名肥胖成年患者(NPWT:150 例,非 NPWT:210 例)接受了 TKA,两组的基线特征相似。与非 NPWT 组相比,NPWT 组的伤口裂开发生率降低了 50%(3.33% vs. 9.52%;P<.05),SSI 发生率也显著降低(11.33% vs. 25.24%;P<.05),包括假体关节感染(4.0% vs. 10.0%;P<.05)和浅表伤口感染(7.33% vs. 15.24%;P<.05)。此外,NPWT 组因任何原因需要返回手术室进行新干预的比例也低于非 NPWT 组(2.67% vs. 9.05%;P=.0107)。常规切口 NPWT 可显著降低肥胖患者 TKA 后伤口裂开和 SSI 的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c4/9259126/e93b781a4ba5/medi-101-e29641-g001.jpg

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