Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Shatin, Hong Kong SAR.
Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong SAR.
BMC Musculoskelet Disord. 2023 May 5;24(1):351. doi: 10.1186/s12891-023-06470-2.
Wound complication, skin blister formation in particular, causes devastating consequences after total knee arthroplasty (TKA). Negative Pressure Wound Therapy (NPWT) tries to improve wound management leading to decrease length of hospital stay and better clinical outcomes. Low body mass index (BMI) could play a part in wound recovery management although lacking evidence. This study compared length of hospital stay and clinical outcomes between NPWT and Conventional groups, and factors affected and how BMI affected.
This was a retrospective clinical record review of 255 (160 NPWT and 95 Conventional) patients between 2018 and 2022. Patient demographics including body mass index (BMI), surgical details (unilateral or bilateral), length of hospital stay, clinical outcomes including skin blisters occurrence, and major wound complications were investigated.
Mean age of patients at surgery was 69.95 (66.3% were female). Patients treated with NPWT stayed significantly longer in the hospital after joint replacement (5.18 days vs. 4.55 days; p = 0.01). Significantly fewer patients treated with NPWT found to have blisters (No blisters: 95.0% vs. 87.4%; p = 0.05). In patients with BMI < 30, percentage of patients requiring dressing change was significantly lower when treated with NPWT than conventional (0.8% vs. 33.3%).
Percentage of blisters occurrence in patients who underwent joint replacement surgery is significantly lower using NPWT. Patients using NPWT stayed significantly longer in the hospital after surgery because significant proportion received bilateral surgery. NPWT patients with BMI < 30 were significantly less likely to change wound dressing.
全膝关节置换术后（TKA），伤口并发症，尤其是皮肤水疱形成，会导致严重后果。负压伤口治疗（NPWT）试图改善伤口管理，从而缩短住院时间并获得更好的临床结果。低体重指数（BMI）可能在伤口恢复管理中发挥作用，但缺乏证据。本研究比较了 NPWT 组和常规组的住院时间和临床结果，以及影响因素和 BMI 的影响。
这是一项回顾性临床病历研究，纳入了 2018 年至 2022 年间的 255 例（160 例 NPWT 和 95 例常规）患者。调查了患者的人口统计学特征，包括体重指数（BMI）、手术细节（单侧或双侧）、住院时间、临床结果，包括皮肤水疱的发生以及主要伤口并发症。
手术时患者的平均年龄为 69.95 岁（66.3%为女性）。关节置换术后，NPWT 组患者的住院时间明显延长（5.18 天 vs. 4.55 天；p=0.01）。NPWT 组患者水疱发生率明显较低（无水疱：95.0% vs. 87.4%；p=0.05）。BMI<30 的患者中，NPWT 组患者需要更换敷料的比例明显低于常规组（0.8% vs. 33.3%）。
使用 NPWT 进行关节置换手术的患者水疱发生率明显较低。接受 NPWT 的患者术后住院时间明显延长，因为相当一部分患者接受了双侧手术。BMI<30 的 NPWT 患者更换伤口敷料的可能性明显较低。
