Lu Shengwei, Yuan Zan, He Xinning, Du Zhiyong, Wang Ying
Department of Spine, The Orthopedics Hospital of Traditional Chinese Medicine Zhuzhou City, Zhuzhou, China.
Int Wound J. 2024 Jan;21(1):e14378. doi: 10.1111/iwj.14378. Epub 2023 Sep 11.
To systematically assess the effect of negative pressure wound therapy (NPWT) on postoperative surgical wound infection, length of hospital stay and postoperative complications after spinal surgery. Relevant studies on the application of NPWT in spinal surgery were conducted via a computerised database search, including PubMed, EMBASE, Web of Science, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang, from inception to June 2023. The identified literature was rigorously screened and data extraction was performed by two investigators independently. The quality of the relevant studies was evaluated using the Newcastle-Ottawa scale (NOS). The effect size for count data was determined by the odds ratio (OR), while the impact size for measurement data was expressed as the standardised mean difference (SMD). The 95% confidence interval (CI) was calculated for each effect magnitude. Stata 17.0 software was used for the meta-analysis. Ten papers, totalling 1448 patients, were finally included. This study demonstrated that NPWT led to a statistically significant reduction in the occurrence of postoperative surgical wound infections (OR: 0.377, 95% CI: 0.238-0.598, p < 0.001), fewer postoperative complications (OR: 0.526, 95% CI: 0.360-0.770, p = 0.001) and a shortened hospital stay (SMD: -0.678, 95%CI: -1.324 to -0.031, p = 0.040) after spinal surgery compared with the control group. When compared with other treatment approaches, NPWT also demonstrated a substantial reduction in surgical wound infections and postoperative complications, as well as a shorter duration of hospitalisation after spinal surgery.
系统评估负压伤口治疗(NPWT)对脊柱手术后手术伤口感染、住院时间和术后并发症的影响。通过计算机数据库检索开展了关于NPWT在脊柱手术中应用的相关研究,检索数据库包括PubMed、EMBASE、Web of Science、MEDLINE、Cochrane图书馆、中国知网(CNKI)和万方,检索时间从建库至2023年6月。对纳入的文献进行严格筛选,由两名研究者独立进行数据提取。使用纽卡斯尔-渥太华量表(NOS)评估相关研究的质量。计数资料的效应量采用比值比(OR)确定,计量资料的效应量采用标准化均数差(SMD)表示。计算每个效应量的95%置信区间(CI)。采用Stata 17.0软件进行荟萃分析。最终纳入10篇论文,共1448例患者。本研究表明,与对照组相比,NPWT可使脊柱手术后手术伤口感染的发生率显著降低(OR:0.377,95%CI:0.238 - 0.598,p < 0.001),术后并发症减少(OR:0.526,95%CI:0.360 - 0.770,p = 0.001),住院时间缩短(SMD:-0.678,95%CI:-1.324至-0.031,p = 0.040)。与其他治疗方法相比,NPWT在脊柱手术后也显著降低了手术伤口感染和术后并发症的发生率,并缩短了住院时间。