Kahveci Ramazan
Department of Plastic Reconstructive and Aesthetic Surgery, Bursa Uludağ University, Bursa, Turkey.
Eplasty. 2022 Nov 22;22:e60. eCollection 2022.
Complex wounds are associated with a challenging healing process, prolonged hospitalization, increased treatment cost, and workforce loss. In this case series, negative pressure wound therapy (NPWT) with and without instillation and dwell time (NPWTi-d), closed incision negative pressure therapy (ciNPT), and open abdomen negative pressure therapy (OA-NPT) use in the management of complex wounds were examined.
Fifty-nine patients (mean age, 55.0 ± 14.8 years) across secondary and tertiary care centers in Turkey were treated. Patients were examined, and a NPWT system was selected based on wound care needs. Dressing changes occurred every 2 to 7 days, depending on therapy type. Wound closure occurred through surgical closure or secondary intention.
Patient wound types consisted of acute wounds (n = 10), chronic wounds (n = 34), postoperative wound dehiscence (n = 9), and tumor resection/flap necrosis (n = 6). Thirty-six patients (61.0%) received NPWT, 16 (27.1%) received NPWTi-d, 5 (8.5%) received ciNPT, and 2 (3.4%) received OA-NPT. Average treatment duration was 19.7 ± 13.7 days. Surgical closure occurred in 45 patients, and secondary closure was observed in 13 patients; the remaining patient showed wound improvement. Wound healing complications were observed in 2 patients (scar formation and partial flap necrosis).
Our findings indicate an association of negative pressure therapy with favorable wound healing outcome in complex wounds. Negative pressure therapy seems to be a useful treatment option to bridge wound care between initial debridement and final reconstruction.
复杂伤口愈合过程具有挑战性，会导致住院时间延长、治疗成本增加以及劳动力损失。在本病例系列中，研究了使用和不使用灌注及停留时间的负压伤口治疗（NPWT）、封闭切口负压治疗（ciNPT）以及开放腹部负压治疗（OA-NPT）在复杂伤口管理中的应用。
对土耳其二级和三级护理中心的59例患者（平均年龄55.0±14.8岁）进行了治疗。对患者进行检查，并根据伤口护理需求选择NPWT系统。根据治疗类型，每2至7天更换一次敷料。伤口通过手术缝合或二期愈合实现闭合。
患者的伤口类型包括急性伤口（n = 10）、慢性伤口（n = 34）、术后伤口裂开（n = 9）以及肿瘤切除/皮瓣坏死（n = 6）。36例患者（61.0%）接受了NPWT，16例（27.1%）接受了NPWTi-d，5例（8.5%）接受了ciNPT，2例（3.4%）接受了OA-NPT。平均治疗持续时间为19.7±13.7天。45例患者进行了手术缝合，13例患者观察到二期愈合；其余患者伤口情况改善。2例患者出现伤口愈合并发症（瘢痕形成和部分皮瓣坏死）。
我们的研究结果表明负压治疗与复杂伤口良好的愈合结果相关。负压治疗似乎是在初始清创和最终重建之间衔接伤口护理的一种有用治疗选择。
