Department of Plastic Surgery , Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Department of Plastic Surgery, Beijing Hospital, Beijing, China.
BMC Musculoskelet Disord. 2023 Oct 19;24(1):827. doi: 10.1186/s12891-023-06970-1.
The flap closed-incisions healing after 3D-printed prosthesis implantation in Chronic Osteomyelitis with Soft Tissue Defects (COSTD) is critical. This study aimed to explore the safety and effectiveness of Negative Pressure Wound Therapy (NPWT) in promoting flap closed-incisions healing.
Retrospective analysis of clinical data was performed, including baseline, surgical and hospitalization information. The efficacy of NPWT was assessed by comparing the ASEPSIS scores, Visual Analogue Scale (VAS), Activity of Daily Living Scale (ADLS), and Lower Extremity Functional Scale (LEFS), as well as the major postoperative complications.
The study included 20 patients, 13 received conventional dressing (Control group) and 7 received NPWT treatment (NPWT group). These two groups exhibited a notable disparity in the distribution of ASEPSIS scores, and the median scores were 24 in Control group and 9 in NPWT group (p = 0.001). Eight patients in the Control group experienced major incisional complications, including 7 cases of exudation, 3 cases of infection, 2 cases of non-healing, and 1 case of dehiscence, while none were observed in the NPWT group (p = 0.015). The VAS, ADLS, and LEFS scores were significantly improved in the NPWT group compared to the Control group (p = 0.003, 0.017, and 0.043, respectively).
The study findings suggest that NPWT applied to the healing process of flap closed-incisions after 3D prosthesis implantation in patients with COSTD can reduce the occurrence of postoperative major complications and promote the recovery of lower limb function and daily activities, which should be recommended for clinical practice.
在伴有软组织缺损的慢性骨髓炎（COSTD）患者中，三维打印假体植入术后皮瓣闭合切口的愈合至关重要。本研究旨在探讨负压伤口治疗（NPWT）在促进皮瓣闭合切口愈合方面的安全性和有效性。
回顾性分析了临床资料，包括基线、手术和住院信息。通过比较 ASEPSIS 评分、视觉模拟评分（VAS）、日常生活活动量表（ADLS）和下肢功能量表（LEFS），以及主要术后并发症，评估 NPWT 的疗效。
本研究共纳入 20 例患者，其中 13 例接受常规敷料治疗（对照组），7 例接受 NPWT 治疗（NPWT 组）。两组 ASEPSIS 评分分布差异显著，对照组中位数为 24 分，NPWT 组中位数为 9 分（p=0.001）。对照组 8 例患者发生主要切口并发症，包括 7 例渗出、3 例感染、2 例不愈合和 1 例裂开，而 NPWT 组无一例发生（p=0.015）。与对照组相比，NPWT 组 VAS、ADLS 和 LEFS 评分均显著改善（p=0.003、0.017 和 0.043）。
本研究结果表明，NPWT 应用于 COSTD 患者 3D 假体植入后皮瓣闭合切口的愈合过程中，可减少术后主要并发症的发生，促进下肢功能和日常活动的恢复，值得在临床实践中推广。
