Tsukazaki Yuhei, Enomoto Hiroya, Takeuchi Nana, Ushigome Takuro, Suwa Katsuhito, Okamoto Tomoyoshi, Eto Ken
Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan.
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
J Anus Rectum Colon. 2024 Jul 30;8(3):157-162. doi: 10.23922/jarc.2023-059. eCollection 2024.
Laparotomy for lower intestinal perforation is associated with a high incidence of surgical site infections. This study aimed to assess whether incisional negative pressure wound therapy (iNPWT) could reduce the incidence of these infections and wound dehiscence in patients with lower intestinal perforation.
This single-center prospective study was conducted between September 2019 and July 2022. In the therapy group, wounds were closed with subcuticular sutures, and iNPWT was applied at -120 mmHg for 5 days. A total of 10 days of iNPWT was employed. These patients were compared with a historical control group. The iNPWT group (Group A) comprised 22 patients.The historical control group (Group B) had 65 patients. Table outlines patient characteristics and compares the two study groups.
Patient characteristics were demographically similar. The incidence of surgical site infections was lower in the therapy group than in the control group (9.1% vs. 52.3%, < 0.001). Wound dehiscence was not observed in the therapy group but was noted in three patients (4.6%) in the control group. In univariate and multivariate analysis, an application of the therapy device was associated with reduced incidence of surgical site infections ( < 0.001 and = 0.002, respectively).
The application of iNPWT in patients with lower intestinal perforation was associated with reduced surgical site infections.
剖腹手术治疗下消化道穿孔与手术部位感染的高发生率相关。本研究旨在评估切口负压伤口治疗（iNPWT）是否能降低下消化道穿孔患者手术部位感染和伤口裂开的发生率。
本单中心前瞻性研究于2019年9月至2022年7月进行。治疗组采用皮下缝合关闭伤口，并以-120 mmHg的负压进行iNPWT治疗5天，共进行10天的iNPWT治疗。将这些患者与一个历史对照组进行比较。iNPWT组（A组）有22例患者。历史对照组（B组）有65例患者。表中列出了患者特征并比较了两个研究组。
两组患者的人口统计学特征相似。治疗组手术部位感染的发生率低于对照组（9.1%对52.3%，P<0.001）。治疗组未观察到伤口裂开，而对照组有3例患者（4.6%）出现伤口裂开。在单因素和多因素分析中，使用该治疗设备与手术部位感染发生率降低相关（分别为P<0.001和P = 0.002）。
iNPWT应用于下消化道穿孔患者可降低手术部位感染的发生率。
