Nakanishi Ryo, Ozawa Heita, Toyota Naoyuki, Akutsu Ritsuto, Fujita Shin
Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan.
Surg Today. 2025 May;55(5):646-651. doi: 10.1007/s00595-024-02983-y. Epub 2024 Dec 27.
Recent findings suggest that utilizing negative pressure wound therapy (NPWT) concurrently with stoma closure may decrease the risk of incisional surgical site infection (iSSI). However, the specific impact of NPWT on iSSI after stoma closure remains unclear. This study investigated the impact of NPWT on SSI after stoma closure.
Between January, 2010 and December, 2022, 185 patients underwent stoma closure at our hospital. Multivariate analysis was conducted to identify the risk factors for iSSI, using logistic regression analysis. Propensity score matching (PSM) was performed to balance the effect of potential co-factors of stoma closure with and without NPWT, on the incidence of superficial SSIs.
Multivariate analysis identified that the absence of NPWT was an independent risk factor for iSSIs (Odds ratio [OR]: 11.1; 95% confidence interval [CI]: 1.88-64.9; P = 0.0078). Following cohort matching, the NPWT-absence and NPWT-presence groups comprised 54 patients each. The incisional SSI rate was significantly lower in the NPWT-presence group than in the NPWT-absence group (0.9%; n = 1 vs. 7.4%; n = 8, respectively; OR: 9.2; 95% CI 1.11-76.4; P = 0.04).
The findings of this study demonstrated that stoma closure with NPWT reduced the SSI rates remarkably. Therefore, NPWT should be considered for stoma closure procedures.
最近的研究结果表明,在造口关闭术同时使用负压伤口治疗(NPWT)可能会降低手术切口部位感染(iSSI)的风险。然而,NPWT对造口关闭术后iSSI的具体影响仍不清楚。本研究调查了NPWT对造口关闭术后手术部位感染(SSI)的影响。
2010年1月至2022年12月期间,我院有185例患者接受了造口关闭术。采用逻辑回归分析进行多因素分析,以确定iSSI的危险因素。进行倾向得分匹配(PSM),以平衡使用和不使用NPWT的造口关闭潜在共同因素对浅表SSIs发生率的影响。
多因素分析确定,未使用NPWT是iSSIs的独立危险因素(比值比[OR]:11.1;95%置信区间[CI]:1.88 - 64.9;P = 0.0078)。队列匹配后,未使用NPWT组和使用NPWT组各有54例患者。使用NPWT组的切口SSI率显著低于未使用NPWT组(分别为0.9%;n = 1 vs. 7.4%;n = 8;OR:9.2;95% CI 1.11 - 76.4;P = 0.04)。
本研究结果表明,使用NPWT进行造口关闭术可显著降低SSI率。因此,在造口关闭手术中应考虑使用NPWT。