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负压伤口治疗对造口回纳术后伤口愈合的有效性:一项随机对照研究。

The effectiveness of negative-pressure wound therapy for wound healing after stoma reversal: a randomized control study.

作者信息

Kang Sung Il, Kim Sohyun

机构信息

Department of Surgery, Yeungnam University Medical Center, Yeungnam Uiversity College of Medicine, Daegu, Korea.

出版信息

Ann Surg Treat Res. 2023 Sep;105(3):126-132. doi: 10.4174/astr.2023.105.3.126. Epub 2023 Sep 1.

Abstract

PURPOSE

The purse-string closure (PSC) method is used for skin closure after stoma reversal to reduce surgical site infections (SSIs). However, PSC requires a longer healing period than primary closure. The application of negative-pressure wound therapy (NPWT) may reduce the healing period of many wound types. This study aimed to investigate whether the application of NPWT promotes wound healing after the PSC method for stoma reversal.

METHODS

This study was a randomized controlled study. Patients who had undergone stoma reversal surgery were randomized to receive NPWT or simple dressing after surgery. The primary outcome was a complete wound-healing period. We also investigated SSI, hospital stay, total cost, and the patient and observer scar assessment scale (POSAS) as secondary outcomes.

RESULTS

A total of 36 patients were randomized into 2 groups. The median wound healing period was shorter in the NPWT group than in the control group (17.5 days [range, 11-24 days] 21.5 days [range, 14-41 days], P = 0.006). SSI rate and hospital stay did not differ between the groups. However, the number of dressings was lower in the NPWT group than in the control group (5 [range, 3-7] 17 [range, 10-30], P < 0.001). The total cost for dressing was comparable between the groups. The POSAS was not different between the groups.

CONCLUSION

This study revealed that NPWT application after PSC for stoma reversal site is effective in reducing the wound healing period compared to simple dressing, without increasing SSI and total cost.

摘要

目的

荷包缝合(PSC)法用于造口回纳术后的皮肤缝合,以减少手术部位感染(SSI)。然而,与一期缝合相比,PSC需要更长的愈合期。负压伤口治疗(NPWT)的应用可能会缩短多种伤口类型的愈合期。本研究旨在探讨NPWT的应用是否能促进造口回纳术后采用PSC法的伤口愈合。

方法

本研究为随机对照研究。接受造口回纳手术的患者术后被随机分为接受NPWT组或单纯换药组。主要结局为伤口完全愈合期。我们还将手术部位感染、住院时间、总费用以及患者和观察者瘢痕评估量表(POSAS)作为次要结局进行了调查。

结果

共有36例患者被随机分为2组。NPWT组的中位伤口愈合期短于对照组(17.5天[范围为11 - 24天]对21.5天[范围为14 - 41天],P = 0.006)。两组之间的手术部位感染率和住院时间无差异。然而,NPWT组的换药次数低于对照组(5次[范围为3 - 7次]对17次[范围为10 - 30次],P < 0.001)。两组之间的换药总费用相当。两组之间的POSAS无差异。

结论

本研究表明,与单纯换药相比,造口回纳部位采用PSC法后应用NPWT可有效缩短伤口愈合期,且不增加手术部位感染和总费用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aa5/10485349/bc0862c9340f/astr-105-126-g001.jpg

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