Abstract：
BACKGROUND: Negative pressure wound therapy (NPWT) is part of the temporary abdominal closure in the treatment of patients with traumatic, inflammatory, or vascular disease. However, the use of NPWT when performing an intestinal anastomosis has been controversial. This study aimed to describe the patients managed with NPWT therapy and identify the risk factors for anastomotic dehiscence when intestinal anastomosis was performed.
METHODS: A single-center cohort study with prospectively collected databases was performed. Patients who required NPWT therapy from January 2014 to December 2018 were included. Patients were stratified according to the performance of intestinal anastomosis and according to the presence of dehiscence. Bivariate and multivariate analyses were performed for anastomotic dehiscence and mortality.
RESULTS: A total of 97 patients were included. Median age was 52 y old [interquartile range 24.5-70]. Male patients corresponded to 75.6% (n = 34) of the population. Delayed fascial closure was performed in 80% (n = 36). The risk of anastomotic dehiscence was higher in females (odds ratio (OR) 11.52 [confidence interval (CI) 1.29-97.85], P = 0.030), delayed fascial closure (OR 18.18 [CI 2.02-163.5], P = 0.010) and use of vasopressors (OR 12.04 [CI 1.22-118.47], P = 0.033). NPWT pressures >110 mmHg were evidenced in the dehiscence group with statistically significant value (OR 1.2 [0.99-2.26] p 0.04) CONCLUSIONS: There is still controversy in the use of NPWT when performing intestinal anastomosis. According to our data, the risk of dehiscence is higher in females, delayed fascial closure, use of vasopressors, and NPWT pressures >110 MMHG.
METHODS: A single-center cohort study with prospectively collected databases was performed. Patients who required NPWT therapy from January 2014 to December 2018 were included. Patients were stratified according to the performance of intestinal anastomosis and according to the presence of dehiscence. Bivariate and multivariate analyses were performed for anastomotic dehiscence and mortality.
RESULTS: A total of 97 patients were included. Median age was 52 y old [interquartile range 24.5-70]. Male patients corresponded to 75.6% (n = 34) of the population. Delayed fascial closure was performed in 80% (n = 36). The risk of anastomotic dehiscence was higher in females (odds ratio (OR) 11.52 [confidence interval (CI) 1.29-97.85], P = 0.030), delayed fascial closure (OR 18.18 [CI 2.02-163.5], P = 0.010) and use of vasopressors (OR 12.04 [CI 1.22-118.47], P = 0.033). NPWT pressures >110 mmHg were evidenced in the dehiscence group with statistically significant value (OR 1.2 [0.99-2.26] p 0.04) CONCLUSIONS: There is still controversy in the use of NPWT when performing intestinal anastomosis. According to our data, the risk of dehiscence is higher in females, delayed fascial closure, use of vasopressors, and NPWT pressures >110 MMHG.
摘要：
背景：负压伤口治疗（NPWT）是创伤患者临时腹部闭合治疗的一部分，炎症，或血管疾病。然而,在进行肠吻合术时使用NPWT一直存在争议.这项研究旨在描述接受NPWT治疗的患者，并确定进行肠吻合时吻合口裂开的危险因素。
方法：采用前瞻性收集的数据库进行单中心队列研究。纳入2014年1月至2018年12月需要NPWT治疗的患者。根据肠吻合的表现和裂开的存在对患者进行分层。对吻合口裂开和死亡率进行了双变量和多变量分析。
结果：共纳入97例患者。中位年龄为52岁[四分位距24.5-70]。男性患者占人口的75.6％（n=34）。延迟筋膜闭合的比例为80％（n=36）。女性吻合口裂开的风险较高（比值比（OR）11.52[置信区间（CI）1.29-97.85]，P=0.030),延迟筋膜闭合（OR18.18[CI2.02-163.5]，P=0.010）和血管升压药的使用（OR12.04[CI1.22-118.47]，P=0.033)。NPWT压力>110mmHg在裂开组中得到证实，具有统计学意义（OR1.2[0.99-2.26]p0.04）。结论：在进行肠吻合时，使用NPWT仍然存在争议。根据我们的数据,女性开裂的风险更高，延迟筋膜闭合,使用血管升压药，和NPWT压力>110MMHG。
方法：采用前瞻性收集的数据库进行单中心队列研究。纳入2014年1月至2018年12月需要NPWT治疗的患者。根据肠吻合的表现和裂开的存在对患者进行分层。对吻合口裂开和死亡率进行了双变量和多变量分析。
结果：共纳入97例患者。中位年龄为52岁[四分位距24.5-70]。男性患者占人口的75.6％（n=34）。延迟筋膜闭合的比例为80％（n=36）。女性吻合口裂开的风险较高（比值比（OR）11.52[置信区间（CI）1.29-97.85]，P=0.030),延迟筋膜闭合（OR18.18[CI2.02-163.5]，P=0.010）和血管升压药的使用（OR12.04[CI1.22-118.47]，P=0.033)。NPWT压力>110mmHg在裂开组中得到证实，具有统计学意义（OR1.2[0.99-2.26]p0.04）。结论：在进行肠吻合时，使用NPWT仍然存在争议。根据我们的数据,女性开裂的风险更高，延迟筋膜闭合,使用血管升压药，和NPWT压力>110MMHG。
