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为骶骨压疮行结肠造口术:一项单中心回顾性研究

Creating Colostomies for Sacral Pressure Ulcers: A Single-Centre Retrospective Study.

作者信息

Tseng Hsu-Ping, Tzeng Yuan-Sheng, Wu Shu-Yu, Wu Chien-Ju, Wang Lin-Yin, Yang Shih-Wei, Liu Shih-Hung, Chang Ching-Han, Lai Kuan-Hung

机构信息

Division of Plastic and Reconstruction Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Int Wound J. 2025 Sep;22(9):e70737. doi: 10.1111/iwj.70737.

Abstract

Faecal contamination of sacral pressure ulcers occurs frequently, so, theoretically, faecal diversion using colostomies is a useful procedure. We retrospectively analysed the data of adult patients for whom colostomies were created to enhance wound healing and compared patients with sacral pressure ulcers who received colostomies and those who did not during the same period. Patients' characteristics analysed included age, gender, comorbidities, WBC count, serum CRP level and microbial profile (before creating colostomy). Additionally, we examined whether the wound was closed, the recurrence rate after wound closure, and mortality outcomes. Regression analysis indicated that colostomy creation was associated with fewer species of gut microbiota cultured and lower rates of wound dehiscence after closure; no association was found between colostomy and mortality. Colostomies help promote wound healing of sacral pressure ulcers after closure by eradicating wound infection, and do not increase patients' mortality rates.

摘要

骶骨压疮的粪便污染经常发生,因此,从理论上讲,采用结肠造口术进行粪便改道是一种有用的手术。我们回顾性分析了为促进伤口愈合而进行结肠造口术的成年患者的数据,并比较了同期接受结肠造口术和未接受结肠造口术的骶骨压疮患者。分析的患者特征包括年龄、性别、合并症、白细胞计数、血清CRP水平和微生物谱(结肠造口术前)。此外,我们检查了伤口是否愈合、伤口闭合后的复发率以及死亡率结果。回归分析表明,结肠造口术与培养出的肠道微生物种类较少以及闭合后伤口裂开率较低有关;未发现结肠造口术与死亡率之间存在关联。结肠造口术通过消除伤口感染有助于促进骶骨压疮闭合后的伤口愈合,且不会增加患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/268d/12380474/f6debab2507d/IWJ-22-e70737-g002.jpg

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