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探索文献中手术伤口裂开的定义:一项范围综述

Exploring the definition of surgical wound dehiscence in literature: a Scoping Review.

作者信息

Muller-Sloof Emmy, de Laat Erik, Zwanenburg Pieter, Wijlens Anke, Vermeulen Hester, Hummelink Stefan, Ulrich Dietmar

机构信息

Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen (634), the Netherlands; Department of Vascular Surgery, Erasmus University Medical Center, Dr. Molenwaterplein 40, 3015 GD, Rotterdam (Rg219), the Netherlands.

Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen (634), the Netherlands.

出版信息

J Tissue Viability. 2024 Nov;33(4):923-929. doi: 10.1016/j.jtv.2024.09.006. Epub 2024 Sep 24.

Abstract

BACKGROUND

Surgical wound dehiscence (SWD) is interpreted differently amongst healthcare professionals due to a lack of uniformity in definitions in literature. Inconsistent defining impedes accurate diagnosis, appropriate care, intercollegiate consultation, and benchmarking. Despite the introduction of a consensus-driven definition by the World Union of Wound Healing Societies (WUWHS) in 2018, its application in literature and clinical practice remains unclear.

A OBJECTIVES

This scoping review aims to systematically explore the literature to identify existing SWD definitions, provide an overview, identify knowledge gaps, and extract articles that reference the WUWHS definition.

METHODS

This review was performed in accordance with the PRISMA-ScR guidelines and Joanna Briggs Institute Methodology for Scoping Reviews. A systematic literature search was performed through MEDLINE, EMBASE, Cochrane Library and Google Scholar. Eligibility screening and data extraction were independently performed by two researchers.

RESULTS

This study included 34 articles: 28 systematic reviews, two randomized clinical trials, three retrospective studies, and one book chapter. SWD was defined in different ways, such as "breakdown/disruption of the surgical wound" (n = 17), "separation/splitting apart of the wound edges" (n = 13), "gaping/re-opened wound" (n = 7), mechanical failure (n = 2), or infection (n = 1). Other studies defined SWD in relation to its depth (skin layers involved) or length over the incision, both complete and partial (n = 9). One study referenced the WUWHS definition.

CONCLUSION

Existing literature demonstrates a substantial variety in defining SWD, and little adoption of the WUWHS definition following its introduction in 2018. Uniform use of the definition should be considered as this will improve the quality of care.

摘要

背景

由于文献中定义缺乏一致性,外科伤口裂开(SWD)在医疗专业人员中的解释存在差异。定义不一致阻碍了准确诊断、适当护理、校际会诊和基准设定。尽管世界伤口愈合协会联盟(WUWHS)在2018年引入了基于共识的定义,但其在文献和临床实践中的应用仍不明确。

目的

本范围综述旨在系统地探索文献,以确定现有的SWD定义,提供概述,识别知识差距,并提取引用WUWHS定义的文章。

方法

本综述按照PRISMA-ScR指南和乔安娜·布里格斯研究所范围综述方法进行。通过MEDLINE、EMBASE、Cochrane图书馆和谷歌学术进行系统的文献检索。两名研究人员独立进行资格筛选和数据提取。

结果

本研究纳入34篇文章:28篇系统综述、两项随机临床试验、三项回顾性研究和一章书籍内容。SWD的定义方式各不相同,例如“手术伤口破裂/中断”(n = 17)、“伤口边缘分离/裂开”(n = 13)、“伤口裂开/重新裂开”(n = 7)、机械故障(n = 2)或感染(n = 1)。其他研究根据其深度(涉及的皮肤层)或切口上的长度(完整和部分)定义SWD(n = 9)。一项研究引用了WUWHS定义。

结论

现有文献表明,在定义SWD方面存在很大差异,2018年WUWHS定义引入后很少被采用。应考虑统一使用该定义,因为这将提高护理质量。

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