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封闭切口负压伤口疗法对脊柱手术患者手术部位伤口感染发生率的影响:一项荟萃分析。

Influence of closed-incision negative-pressure wound therapy on the incidence of surgical site wound infection in patients undergoing spine surgery: A meta-analysis.

机构信息

Department of Orthopedics, Jincheng General Hospital, Jincheng, China.

出版信息

Int Wound J. 2023 Dec;20(10):4193-4199. doi: 10.1111/iwj.14317. Epub 2023 Jul 30.

Abstract

The present meta-analysis was conducted to comprehensively assess the impact of closed-incision negative-pressure wound therapy (ciNPWT) on the incidence of surgical site infections (SSIs) in patients undergoing spinal fusion surgery, thereby aiming to provide evidence-based support for the prevention of postoperative wound infections during spinal surgery. Relevant studies pertaining to the application of ciNPWT in spinal surgery were retrieved through searches of the PubMed, Embase, MEDLINE and Cochrane Library databases, spanning from their inception to May 2023. The literature screening and data extraction were performed by two researchers based on predefined inclusion and exclusion criteria, followed by a quality assessment of the included studies. Meta-analyses were performed using the odds ratios (ORs) and standardised mean differences (SMDs) as effect variables. RevMan 14.0 and STATA 17.0 were employed for meta-analysis of the extracted data. In total, eight articles involving 1198 patients, including 391 in the experimental group and 807 in the control group, were included. The meta-analysis results revealed that ciNPWT significantly reduced the incidence of SSIs in patients undergoing spinal fusion surgery (OR, 0.39; 95% CI: 0.22-0.67, p = 0.0007); however, it did not lead to a reduction in hospital stay duration (SMD: -0.48, 95% CI: -0.98 to 0.01, p = 0.06). Existing evidence suggests that ciNPWT has a positive impact on patients undergoing spinal fusion surgery, as it significantly reduces the incidence of postoperative surgical site wound infections; however, it does not result in a shorter hospital stay for patients.

摘要

本次荟萃分析旨在全面评估密闭切口负压伤口治疗(ciNPWT)对脊柱融合手术患者手术部位感染(SSI)发生率的影响,从而为脊柱手术中预防术后伤口感染提供循证支持。通过检索 PubMed、Embase、MEDLINE 和 Cochrane Library 数据库,检索了有关 ciNPWT 在脊柱手术中应用的相关研究,检索时间从建库至 2023 年 5 月。两名研究人员根据预先设定的纳入和排除标准进行文献筛选和数据提取,然后对纳入研究进行质量评估。使用比值比(OR)和标准化均数差(SMD)作为效应变量进行荟萃分析。使用 RevMan 14.0 和 STATA 17.0 对提取的数据进行荟萃分析。共纳入 8 篇文章,涉及 1198 例患者,其中实验组 391 例,对照组 807 例。荟萃分析结果表明,ciNPWT 可显著降低脊柱融合手术患者的 SSI 发生率(OR,0.39;95%CI:0.22-0.67,p=0.0007);但不会导致住院时间缩短(SMD:-0.48,95%CI:-0.98 至 0.01,p=0.06)。现有证据表明,ciNPWT 对脊柱融合手术患者有积极影响,因为它可显著降低术后手术部位伤口感染的发生率;但不会缩短患者的住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a97/10681537/9715d3b6ec4c/IWJ-20-4193-g005.jpg

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