创伤手术中的临时腹部闭合：负压治疗开放性腹部技术之间的比较队列研究

Temporary abdominal closure in trauma surgery: a comparative cohort study between open abdomen techniques with negative pressure therapy.

作者信息

Petrillo Yuri Thomé Machado, da Silva Gabrieli Flesch, Bracht Vitor Steffens, Baldissera Neiva, Fonseca Mariana Kumaira, Cavazzola Leandro Totti

机构信息

Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Feevale University, Novo Hamburgo, Brazil.

出版信息

Langenbecks Arch Surg. 2025 May 16;410(1):159. doi: 10.1007/s00423-025-03725-5.

DOI:10.1007/s00423-025-03725-5

PMID:40377700

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12084225/

Abstract

BACKGROUND

The use of negative pressure therapy (NPT) to maintain an open abdomen (OA) is a well-established practice in trauma surgery. The aim of this study was to compare two techniques for temporary closure of the OA using negative pressure therapy NPT with regard to the outcome of definitive closure of the abdominal wall, the incidence of complications and mortality.

METHODOLOGY

Controlled retrospective cohort study with trauma patients submitted to NPT as a method of maintaining OA. The groups were divided into "Group B", referring to the use of NPT by Barker dressing, and "Group V", referring to the use of NPT by RENASYS™ AB abdominal dressing.

RESULTS

A total of 76 patients were analyzed (Group B, n = 48; Group V, n = 28), with mean age of 34 years, and 92% male. The groups were equivalent in their trauma severity scores. The overall rate of abdominal cavity closure was 38%, higher in Group V than in Group B (46%, n = 13 vs. 33%, n = 16, p = 0.374). The peritoneostomy outcome was significantly higher in group B (48%, n = 23 vs. 21%, n = 6, p = 0.028). Moderate negative correlation was observed between the duration of OA therapy and the rate of definitive closure of the abdominal cavity (ρ -0.637; p < 0.0001). Damage control surgery (DCS) and shorter duration of OA were identified as predictors of closure.

CONCLUSION

OA with NPT by industrial abdominal dressing decreases the rate of peritoniostomy as abdominal wall outcome compared to Barker dressing.

摘要

背景

在创伤外科中，使用负压疗法（NPT）维持开放性腹部（OA）是一种成熟的做法。本研究的目的是比较两种使用负压疗法（NPT）临时闭合开放性腹部（OA）的技术，比较腹壁最终闭合的结果、并发症发生率和死亡率。

方法

对接受NPT作为维持开放性腹部（OA）方法的创伤患者进行对照回顾性队列研究。将这些组分为“B组”，指使用巴克敷料进行NPT；“V组”，指使用RENASYS™ AB腹部敷料进行NPT。

结果

共分析了76例患者（B组，n = 48；V组，n = 28），平均年龄34岁，男性占92%。两组的创伤严重程度评分相当。腹腔闭合的总体率为38%，V组高于B组（46%，n = 13 vs. 33%，n = 16，p = 0.374）。B组的腹膜造口术结果显著更高（48%，n = 23 vs. 21%，n = 6，p = 0.028）。观察到开放性腹部（OA）治疗持续时间与腹腔最终闭合率之间存在中度负相关（ρ -0.637；p < 0.0001）。损伤控制手术（DCS）和较短的开放性腹部（OA）持续时间被确定为闭合的预测因素。