Tao Yixi, Zhang Yusui, Liu Yang, Tang Songjiang
Department of Cardiovascular Medicine, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China.
Interventional Surgery of Radiology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China.
Int Wound J. 2023 Sep 23;21(2). doi: 10.1111/iwj.14398.
We conducted a comprehensive analysis to evaluate the benefits of negative pressure wound therapy (NPWT) versus traditional dressings in preventing surgical site infections in patients undergoing cardiac surgery. We thoroughly examined several databases, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, Chinese Biomedical Literature Database (CBM) and Wanfang, from inception until July 2023. Two independent researchers were responsible for the literature screening, data extraction and quality assessment; analyses were performed using RevMan 5.4 software. Thirteen studies comprising 8495 patients were deemed relevant. A total of 2685 patients were treated with NPWT, whereas 5810 received conventional dressings. The findings revealed that NPWT was more effective in reducing surgical site infections after cardiac surgery than conventional dressings (4.88% vs. 5.87%, odds ratio [OR]: 0.50, 95% confidence intervals [CIs]: 0.40-0.63, p < 0.001). Additionally, NPWT was more effective in reducing deep wound infections (1.48% vs. 4.15%, OR: 0.36, 95% CI: 0.23-0.56, p < 0.001) and resulted in shorter hospital stays (SMD: -0.33, 95% CIs: -0.54 to -0.13, p = 0.001). However, the rate of superficial wound infections was not significantly affected by the method of wound care (3.72% vs. 5.51%, OR: 0.63, 95% CI: 0.32-1.23, p = 0.180). In conclusion, NPWT was shown to be advantageous in preventing postoperative infections and reducing hospital stay durations in patients undergoing cardiac surgery. Nonetheless, given the limitations in the number and quality of the included studies, further research is recommended to validate these findings.
我们进行了一项综合分析，以评估负压伤口治疗（NPWT）与传统敷料在预防心脏手术患者手术部位感染方面的益处。我们全面检索了多个数据库，包括PubMed、EMBASE、Cochrane图书馆、中国知网（CNKI）、维普（VIP）、中国生物医学文献数据库（CBM）和万方数据库，检索时间从建库至2023年7月。两名独立研究人员负责文献筛选、数据提取和质量评估；使用RevMan 5.4软件进行分析。共有13项研究纳入8495例患者。其中2685例患者接受NPWT治疗，5810例接受传统敷料治疗。结果显示，与传统敷料相比，NPWT在降低心脏手术后手术部位感染方面更有效（4.88%对5.87%，比值比[OR]：0.50，95%置信区间[CI]：0.40 - 0.63，p < 0.001）。此外，NPWT在减少深部伤口感染方面更有效（1.48%对4.15%，OR：0.36，95% CI：0.23 - 0.56，p < 0.001），并缩短了住院时间（标准化均数差：-0.33，95% CI：-0.54至-0.13，p = 0.001）。然而，伤口护理方法对浅表伤口感染率无显著影响（3.72%对5.51%，OR：0.63，95% CI：0.32 - 1.23，p = 0.180）。总之，NPWT在预防心脏手术患者术后感染和缩短住院时间方面具有优势。尽管如此，鉴于纳入研究的数量和质量存在局限性，建议进一步开展研究以验证这些结果。
