Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India.
Pol Przegl Chir. 2022 Apr 7;95(1):1-5. doi: 10.5604/01.3001.0015.8170.
<b>Introduction:</b> Negative pressure wound therapy (NPWT) has been suggested as a gold standard for managing complex wounds and to reduce the time of healing and overall morbidity and mortality of the patient. </br></br> <b>Aim:</b> We have done a retrospective study to observe the outcome in patients managed with negative pressure wound therapy for varied etiologies. </br></br> <b> Methods:</b> Patients with complicated wounds including lower limb wounds post-debridement, upper limb wounds post-debridement, postoperative abdominal wound dehiscence, abdominal and chest abscess wounds post-debridement and amputation stumps, managed with negative pressure wound therapy were studied on the basis of wound outcome, total hospital stay, days of NPWT application and pressure and mode of NPWT. </br></br> <b>Results:</b> A total of 42 patients with complicated wounds were included in the study. Mean hospital stay was 16.2 days and mean NPWT application time was 8.29 days with NPWT being applied on average for 3.91 days post-procedure like debridement or amputation or after wound dehiscence in which debridement was not done. As many as 41.5% of wounds were closed with suturing, 48.8% healed by secondary intention and 9.8% were covered with split-thickness skin grafts. A significant observation was made for lower pressure being used for abdominal wound dehiscence (75 mmHg) compared to other wounds on limbs (mean 98.33 mmHg) (P < 0.001). Re-debridement after the 1st cycle of NPWT was needed in 40% of wounds managed with intermittent mode compared to 6.2% in continuous mode (P = 0.028). </br></br> <b>Conclusion:</b> NPWT can reduce and manage wound complications with improvement in the quality of life of patients when used at an appropriate time with knowledge of its mechanism and functionality.
<b>引言:</b>负压伤口疗法(NPWT)已被认为是治疗复杂伤口的金标准,可以减少愈合时间,降低患者的整体发病率和死亡率。</br></br> <b>目的:</b>我们进行了一项回顾性研究,观察了不同病因接受负压伤口治疗的患者的治疗结果。</br></br> <b>方法:</b>根据伤口愈合情况、总住院时间、NPWT 应用天数和压力、NPWT 模式,对接受 NPWT 治疗的下肢清创后伤口、上肢清创后伤口、术后腹部伤口裂开、腹部和胸部脓肿清创后伤口和截肢残端等复杂伤口的患者进行研究。</br></br> <b>结果:</b>本研究共纳入 42 例复杂伤口患者。平均住院时间为 16.2 天,NPWT 应用时间平均为 8.29 天,在清创或截肢或伤口裂开但未行清创术后平均 3.91 天应用 NPWT。41.5%的伤口通过缝合闭合,48.8%的伤口通过二期愈合,9.8%的伤口通过刃厚皮片移植覆盖。观察到腹部伤口裂开(75mmHg)的压力明显低于四肢伤口(平均 98.33mmHg)(P < 0.001)。与连续模式(6.2%)相比,间歇性模式下的 NPWT 第 1 周期后需要再次清创的伤口比例为 40%(P = 0.028)。</br></br> <b>结论:</b>当了解 NPWT 的作用机制和功能并在适当的时间使用时,它可以减少和处理伤口并发症,改善患者的生活质量。