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闭合式切口负压伤口疗法在聚丙烯网片修补腹疝手术中的应用:一项随机临床试验。

Application of Closed Incision Negative Pressure Wound Therapy in Ventral Hernia Repair Surgery Using a Polypropylene Mesh: A Randomized Clinical Trial.

机构信息

Department of Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 708 00 Ostrava-Poruba, Czech Republic.

Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava-Vítkovice, Czech Republic.

出版信息

Medicina (Kaunas). 2024 Sep 22;60(9):1548. doi: 10.3390/medicina60091548.

Abstract

: Surgical site infections (SSIs) are a significant complication following ventral hernia repair, potentially leading to prolonged hospital stays and increased morbidity. This study aimed to evaluate whether closed incision negative pressure wound therapy (ciNPWT) reduces the incidence of SSI after ventral hernia repair with polypropylene mesh compared to standard wound care. : A randomized study was conducted with 100 patients undergoing ventral hernia repair using a polypropylene mesh. Participants were divided into two groups: a control group (n=50), which received standard sterile gauze dressing with an iodine-based disinfectant, and an intervention group (n=50), treated with the ciNPWT system (Vivano by HARTMANN) for 5 days postoperatively. The primary outcome was the incidence of SSI within one year after surgery. Secondary outcomes included the influence of factors such as age, sex, smoking status, and hernia size on SSI occurrence. The study was approved by the Ethics Committee at the University Hospital Ostrava, adhering to the ethical standards of the Helsinki Declaration. : The incidence of SSI was lower in the ciNPWT group compared to the standard care group (4% vs. 12%), though this difference did not reach statistical significance. No significant effect of sex or smoking status on SSI was observed. The control group had a shorter mean length of hospital stay. Larger hernias in the non-ciNPWT group were more prone to SSIs, as expected. : Although limited by a small sample size, the findings suggest that ciNPWT may be associated with a reduced rate of SSI following ventral hernia repair. Further studies with larger populations are needed to confirm these results.

摘要

: 外科部位感染(SSI)是腹疝修补术后的一种严重并发症,可能导致住院时间延长和发病率增加。本研究旨在评估与标准伤口护理相比,使用聚丙稀网片行腹疝修补术后采用闭合切口负压伤口治疗(ciNPWT)是否能降低 SSI 的发生率。: 进行了一项随机研究,共纳入 100 例行聚丙稀网片修补的腹疝患者。参与者分为两组:对照组(n=50)接受标准无菌纱布敷料和含碘消毒剂;干预组(n=50)术后用 ciNPWT 系统(HARTMANN 的 Vivano)治疗 5 天。主要结局为术后 1 年内 SSI 的发生率。次要结局包括年龄、性别、吸烟状况和疝大小等因素对 SSI 发生的影响。该研究经奥斯特拉瓦大学医院伦理委员会批准,符合赫尔辛基宣言的伦理标准。: ciNPWT 组的 SSI 发生率低于标准治疗组(4%比 12%),但差异无统计学意义。性别或吸烟状况对 SSI 无显著影响。对照组的平均住院时间更短。预计非 ciNPWT 组的较大疝更易发生 SSI。: 尽管样本量较小,但研究结果表明,ciNPWT 可能与腹疝修补术后 SSI 发生率降低相关。需要更大人群的进一步研究来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f34/11434378/9283cc147a67/medicina-60-01548-g001.jpg

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