研究真空密封引流与传统负压引流治疗颈椎后路内固定术后深部切口感染的疗效：一项回顾性队列研究。

Investigating the efficacy of vacuum sealing drainage versus traditional negative pressure drainage in treating deep incision infections following posterior cervical internal fixation-a retrospective cohort study.

机构信息

Department of Orthopaedic Surgery, 960th Hospital of PLA, Shifan road, Tianqiao district, Jinan, 250031, China.

出版信息

Eur J Med Res. 2024 Feb 15;29(1):125. doi: 10.1186/s40001-024-01717-7.

DOI:10.1186/s40001-024-01717-7

PMID:38360845

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10868024/

Abstract

BACKGROUND

Assessing the efficacy and safety of Vacuum Sealing Drainage (VSD) in treating deep incision infections (DII) following posterior cervical internal fixation.

METHODS

We retrospectively studied the clinical effects of VSD and Traditional Negative Pressure Drainage (TND) on 12 patients with deep incision infection after posterior cervical fixation surgery who were treated in our department from 2012 to 2020. A comparison of patient-related factors (age, gender, BMI, comorbidities, initial internal fixation surgery segment, preoperative laboratory inflammation indicators) and surgical-related factors (postoperative duration of fever, positive rate of drainage fluid bacterial culture, Visual Analogue Scale (VAS) score at 3 days after surgery, laboratory indicators at 3 days after surgery, debridement frequency and drainage time, hospital stay, internal fixation retention rate, and infection recurrence rate) between the VSD group and the TND group was conducted using independent sample t tests to draw experimental conclusions.

RESULTS

This study included 12 patients, with six cases of VSD (5 males and 1 female) and six cases of TND (4 males and 2 females). The VSD group had significantly lower postoperative fever time (1.50 ± 0.46 days vs. 4.28 ± 0.97 days, P < 0.05), a higher positive rate of bacterial cultures in drainage fluid (5/6 vs. 2/6, P < 0.05), lower 3 day VAS scores (3.13 ± 0.83 vs. 3.44 ± 0.88, P < 0.05), lower 3 day CRP levels (66.89 ± 23.65 mg/L vs. 57.11 ± 18.18 mg/L, P < 0.05), a shorter total drainage time (14.50 ± 2.98 days vs. 22.56 ± 3.01 days, P < 0.05), and a higher total drainage flow rate (395.63 ± 60.97 ml vs. 155.56 ± 32.54 ml, P < 0.05) than the TND group (the total drainage volume throughout the entire treatment process). In addition, the frequency of debridement (2.67 ± 0.52 times vs. 3.17 ± 0.41 times, P < 0.05) and average hospital stay (23.13 ± 3.27 days vs. 34.33 ± 6.86 days, P < 0.05) were significantly lower in the VSD group, although both groups retained internal fixation.

CONCLUSIONS

VSD is a secure and effective treatment for deep incision infections that results from cervical posterior internal fixation surgery.

摘要

背景

评估真空密封引流（VSD）在治疗颈椎后路内固定术后深部切口感染（DII）中的疗效和安全性。

方法

我们回顾性研究了 2012 年至 2020 年期间我科收治的 12 例颈椎后路内固定术后深部切口感染患者采用 VSD 和传统负压引流（TND）治疗的临床效果。采用独立样本 t 检验比较 VSD 组和 TND 组患者相关因素（年龄、性别、BMI、合并症、初始内固定手术节段、术前实验室炎症指标）和手术相关因素（术后发热时间、引流液细菌培养阳性率、术后 3 天 VAS 评分、术后 3 天实验室指标、清创次数和引流时间、住院时间、内固定保留率、感染复发率），得出实验结论。

结果

本研究共纳入 12 例患者，VSD 组 6 例（5 例男性，1 例女性），TND 组 6 例（4 例男性，2 例女性）。VSD 组术后发热时间（1.50±0.46 天 vs. 4.28±0.97 天，P<0.05）、引流液细菌培养阳性率（5/6 例 vs. 2/6 例，P<0.05）、术后 3 天 VAS 评分（3.13±0.83 分 vs. 3.44±0.88 分，P<0.05）、术后 3 天 CRP 水平（66.89±23.65mg/L vs. 57.11±18.18mg/L，P<0.05）、总引流时间（14.50±2.98 天 vs. 22.56±3.01 天，P<0.05）、总引流流量（395.63±60.97ml vs. 155.56±32.54ml，P<0.05）均优于 TND 组（整个治疗过程的总引流量）。此外，VSD 组清创次数（2.67±0.52 次 vs. 3.17±0.41 次，P<0.05）和平均住院时间（23.13±3.27 天 vs. 34.33±6.86 天，P<0.05）均明显低于 TND 组，尽管两组均保留了内固定。