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荷包缝合造口关闭术后使用负压封闭引流的有效性:一项回顾性试验

Usefulness of vacuum-assisted closure after stoma closure with purse string suturing: a retrospective trial.

作者信息

Masumori Koji, Maeda Kotaro, Hanai Tsunekazu, Sato Harunobu, Koide Yoshikazu, Matsuoka Hiroshi, Katsuno Hidetoshi, Endo Tomoyoshi, Cheong Yeongcheol, Uyama Ichiro

机构信息

Department of Gastroenterological Surgery, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.

International Medical Center, Fujita Health University Hospital, Toyoake, Aichi, Japan.

出版信息

Fujita Med J. 2022 Aug;8(3):67-72. doi: 10.20407/fmj.2021-007. Epub 2021 Nov 25.

Abstract

OBJECTIVES

Surgical site infection (SSI) is a problematic complication after stoma closure. The purse string suture (PSS) technique eliminates this problem, but the area takes longer to heal. The present retrospective study was performed to evaluate the usefulness of a vacuum-assisted closure (VAC) system for the promotion of wound healing after stoma closure.

METHODS

Consecutive patients undergoing stoma closure with the PSS technique were divided into two groups: those treated with and without use of the VAC system. The volume of dead space and the size of the wound were measured after stoma closure in both groups. The same measurements were performed on days 3 and 7 after closure. The time needed for wound closure was also examined in both groups. Outcomes were also evaluated according to age, body mass index, operative time, bleeding volume, wound consistency, patient satisfaction, perioperative inflammatory response, occurrence of SSI, and hospitalization days.

RESULTS

The VAC group comprised 31 patients, and the non-VAC group comprised 34 patients. The volume of dead space on days 3 and 7 after closure was significantly smaller in the VAC group than in the non-VAC group (P=0.006 and P<0.001, respectively). The number of SSIs was significantly lower in the VAC group than in the non-VAC group (P=0.014).

CONCLUSION

The dead space volume on days 3 and 7 after stoma closure with PSS significantly decreased by using the VAC system. The incidence of SSI after stoma closure also significantly decreased by using the VAC system.

摘要

目的

手术部位感染(SSI)是造口关闭术后的一个棘手并发症。荷包缝合(PSS)技术可消除这一问题,但该区域愈合时间较长。本回顾性研究旨在评估负压封闭引流(VAC)系统对促进造口关闭术后伤口愈合的有效性。

方法

采用PSS技术进行造口关闭的连续患者被分为两组:使用和不使用VAC系统治疗的患者。两组均在造口关闭后测量死腔容积和伤口大小。在关闭后第3天和第7天进行相同的测量。还对两组伤口愈合所需时间进行了检查。根据年龄、体重指数、手术时间、出血量、伤口情况、患者满意度、围手术期炎症反应、SSI发生率和住院天数对结果进行评估。

结果

VAC组有31例患者,非VAC组有34例患者。VAC组关闭后第3天和第7天的死腔容积明显小于非VAC组(分别为P = 0.006和P < 0.001)。VAC组的SSI数量明显低于非VAC组(P = 0.014)。

结论

使用VAC系统可使采用PSS进行造口关闭后第3天和第7天的死腔容积显著减小。使用VAC系统还可使造口关闭术后SSI的发生率显著降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06a4/9358675/30323b6f72aa/fmj-8-067-g001.jpg

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