关键词: Closed-incision negative pressure therapy Groin incision Patient experience Peripheral arterial surgery Peripheral artery disease Qualitative study Vascular nursing Vascular surgery

Mesh : Humans Vascular Surgical Procedures / adverse effects Groin / blood supply surgery Patient Discharge Activities of Daily Living Negative-Pressure Wound Therapy / adverse effects methods Surgical Wound Infection / etiology Patient Outcome Assessment

来  源:   DOI:10.1016/j.jvn.2023.06.006

Abstract:
Closed-incision negative pressure therapy may lower the risk of surgical site infections in patients after peripheral arterial surgery.
To explore patient experience of negative pressure therapy applied to groin incisions after discharge following peripheral arterial surgery, and to study their perception and attitudes toward the self-care information sheet they received at the vascular department.
A qualitative study underpinned by Gadamer\'s philosophical hermeneutics was conducted semi-structured interviews by telephone around day seven after therapy ended with ten participants. All had received self-care information sheet at the discharge and been home with closed-incision negative pressure therapy for 3-6 days. The participants had open peripheral arterial surgery in the groin in form of femoral thromboendarterectomy. Kvale and Brinkmann\'s research guided the data collection, analysis, and interpretation.
Patients found themselves coping with an unfamiliar situation after peripheral arterial surgery and the need arose to conceal the pump and tubing that were part of their incision treatment to protect their self-image. Their treatment became a constant companion, with some patients viewing the equipment as an extension of their bodies and others feeling its impact on activities of daily living. Patients perceived the treatment as providing reassurance, albeit with constraints, leading to feelings of manageability and an increasing sense of control. They viewed the written information as informative but with room for improvement.
Patient experiences of closed-incision negative pressure therapy on groin incisions after discharge following peripheral arterial surgery showed that they perceived it as safe and manageable. Patients need support, however, in learning how to hide the treatment and to expand their own involvement and improve self-care. The study found that patient involvement and individually tailored information is essential to facilitating a healthy transition from hospital to self-care at home and that written information must be improved further.
摘要:
背景:闭合切口负压治疗可降低外周动脉手术后患者手术部位感染的风险。
目的:探讨外周动脉手术后腹股沟切口应用负压治疗的患者经验,并研究他们对血管科收到的自我护理信息表的看法和态度。
方法:一项以伽达默尔哲学解释学为基础的定性研究是在治疗结束后第7天通过电话进行半结构化访谈,共有10名参与者。所有人都在出院时收到了自我护理信息表,并在家中接受了封闭切口负压治疗3-6天。参与者以股骨血栓内膜切除术的形式在腹股沟进行了开放的外周动脉手术。Kvale和Brinkmann的研究指导了数据收集,分析,和解释。
结果:患者在外周动脉手术后发现自己在应对陌生情况,因此需要隐藏作为切口治疗一部分的泵和管道,以保护自身形象。他们的治疗成为了永恒的伴侣,一些患者将设备视为他们身体的延伸,而另一些患者则感觉到其对日常生活活动的影响。患者认为治疗提供了安慰,尽管有限制,导致可管理性的感觉和越来越多的控制感。他们认为书面信息内容丰富,但仍有改进的空间。
结论:患者在外周动脉手术后出院后对腹股沟切口进行闭合切口负压治疗的经验表明,他们认为这是安全且可控的。病人需要支持,然而,在学习如何隐藏治疗和扩大自己的参与和提高自我保健。研究发现,患者的参与和个性化的信息对于促进从医院到家庭自我护理的健康过渡至关重要,并且必须进一步改善书面信息。
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