Schulz Torsten, Kirsten Toralf, Vogel Katharina Theresa, Langer Stefan, Nuwayhid Rima
Department of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany.
Medical Informatics Center, Department of Medical Data Science, University Hospital Leipzig, 04103 Leipzig, Germany.
JPRAS Open. 2024 Sep 11;42:197-207. doi: 10.1016/j.jpra.2024.09.004. eCollection 2024 Dec.
The effectiveness of closed incision negative pressure wound therapy (ciNPWT) has been shown across various studies. However, studies with large patient cohorts comprising post-bariatric patient populations are missing. The objective of this research was to assess the influence of ciNPWT on post-operative wound complications in this demanding patient collective.
We conducted a retrospective case-control study. Between 1 January 2013 and 31 December 2023, a total of 251 abdominoplasty procedures following massive weight loss were identified. Patients were matched based on resection weights. We matched 118 patients separated into two groups depending on post-surgical wound management (conventional wound dressings vs ciNPWT). The primary outcomes were wound-related disorders and secondary outcomes were the number of readmissions or reoperations within 30 days after the initial surgery.
The study revealed equal incidence of seroma formation (15 vs 15, p = 1.0), rates of wound dehiscence (23 vs 20, p = 0.56), surgical site infection (11 vs 6, p = 0.18), hematoma (17 vs 9, p = 0.07), complete removal of all drainages (6.7 vs 6.1 days, p = 0.34) and total number of readmission (12 vs 11, p = 0.77) or reoperations (12 vs 10, p = 0.63) within 30 days. The second hospital stay caused by revision was significantly shorter in the ciNPWT group (5.8 days vs 12.0 days, p = 0.02).
Consequently, we did not find evidence to support the hypothesis that ciNPWT reduces complications after abdominoplasty in patients with massive weight loss.
多项研究已证实封闭切口负压伤口治疗(ciNPWT)的有效性。然而,缺乏针对大量减肥后患者群体的大型队列研究。本研究的目的是评估ciNPWT对这一特殊患者群体术后伤口并发症的影响。
我们进行了一项回顾性病例对照研究。在2013年1月1日至2023年12月31日期间,共确定了251例大量减肥后的腹壁成形术病例。根据切除重量对患者进行匹配。我们将118例患者根据术后伤口管理方式分为两组(传统伤口敷料与ciNPWT)。主要结局是与伤口相关的疾病,次要结局是初次手术后30天内的再次入院或再次手术次数。
研究显示,两组血清肿形成的发生率相同(15例对15例,p = 1.0),伤口裂开率(23例对20例,p = 0.56)、手术部位感染率(11例对6例,p = 0.18)、血肿发生率(17例对9例,p = 0.07)、所有引流管完全拔除时间(6.7天对6.1天,p = 0.34)以及30天内再次入院总数(12例对11例,p = 0.77)或再次手术次数(12例对10例,p = 0.63)均无差异。ciNPWT组因翻修导致的第二次住院时间明显更短(5.8天对12.0天,p = 0.02)。
因此,我们没有找到证据支持ciNPWT能降低大量减肥患者腹壁成形术后并发症的假设。