传统疗法与滴注式负压伤口疗法治疗开放性骨盆骨折严重软组织损伤的回顾性研究

Conventional versus Instillation Negative-Pressure Wound Therapy for Severe Soft Tissue Injury in Open Pelvic Fractures: A Retrospective Review.

作者信息

Choi Donghwan, Cho Won Tae, Song Hyung Keun, Kwon Junsik, Kang Byung Hee, Jung Hohyung, Kim Min Ji, Jung Kyoungwon

机构信息

Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.

出版信息

Yonsei Med J. 2025 Feb;66(2):94-102. doi: 10.3349/ymj.2023.0473.

DOI:10.3349/ymj.2023.0473

PMID:39894042

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11790408/

Abstract

PURPOSE

We investigated the clinical features, current negative-pressure wound therapy (NPWT) management strategies, and outcomes of pelvic-perineal soft tissue infection after open pelvic fractures.

MATERIALS AND METHODS

We analyzed the data of patients admitted to our trauma center with pelvic-perineal soft tissue after open pelvic fractures over a 7-year period. We investigated the injury severity score (ISS), medical costs, number of NPWTs, time required to reach definite wound coverage, complications, fracture classifications, transfusion requirements, interventions, length of stay (LOS) in hospital and intensive care unit (ICU), and prognosis.

RESULTS

Twenty patients with open pelvic fractures were treated with NPWT, and one patient who underwent NPWT died of pelvic sepsis during ICU treatment. The median LOS in hospital and medical costs were 98 [56-164] days and 106400 [65600-171100] USD, respectively. Patients treated with instillation NPWT (iNPWT, n=10) had a shorter NPWT duration (24 [13-39] vs. 46 [42-91] days, =0.023), time to definite wound coverage (30 [21-43] vs. 49 [42-93] days, =0.026), and hospital LOS (56 [43-72] vs. 158 [101-192] days, =0.001), as well as lower medical costs (67800 [42500-102500] vs. 144200 [110400-236000] USD, =0.009) compared to those treated with conventional NPWT.

CONCLUSION

NPWT is a feasible method for treating pelvic soft tissue infections in patients with open pelvic fractures. iNPWT can reduce the duration of NPWT, hospital LOS, and medical costs.

摘要

目的

我们研究了开放性骨盆骨折后盆腔 - 会阴软组织感染的临床特征、当前负压伤口治疗（NPWT）管理策略及治疗结果。

材料与方法

我们分析了在7年期间因开放性骨盆骨折后盆腔 - 会阴软组织损伤入住我们创伤中心的患者数据。我们调查了损伤严重程度评分（ISS）、医疗费用、NPWT治疗次数、达到明确伤口覆盖所需时间、并发症、骨折分类、输血需求、干预措施、住院时间（LOS）以及在重症监护病房（ICU）的住院时间和预后情况。

结果

20例开放性骨盆骨折患者接受了NPWT治疗，其中1例在ICU治疗期间因盆腔败血症死亡。住院时间中位数和医疗费用分别为98[56 - 164]天和106400[65600 - 171100]美元。与接受传统NPWT治疗的患者相比，接受滴注式NPWT（iNPWT，n = 10）治疗的患者NPWT持续时间更短（24[13 - 39]天对46[42 - 91]天，P = 0.023）、达到明确伤口覆盖的时间更短（30[21 - 43]天对49[42 - 93]天，P = 0.026）、住院时间更短（56[43 - 72]天对158[101 - 192]天，P = 0.001），且医疗费用更低（67800[42500 - 102500]美元对144200[110400 - 236000]美元，P = 0.009）。