Surgical Site Complications

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    文章类型: Journal Article
    手术部位并发症(SSC)对患者构成重大风险,可能导致严重的后果甚至生命损失。虽然先前的研究表明,闭合切口负压治疗(ciNPT)可以减少各种手术领域的伤口并发症,其在腹部切口中的有效性仍不确定。为了解决这个差距,我们进行了系统评价和荟萃分析,以评估ciNPT对腹部开放手术患者术后结局和医疗保健利用的影响.
    使用PubMed进行系统的文献检索,EMBASE,QUOSA是针对英文出版物进行的,将ciNPT与2005年1月至2021年8月期间接受腹部外科手术的患者的护理敷料标准进行比较。研究参与者的特点,外科手术,使用的敷料,治疗持续时间,术后结果,并提取后续数据。采用随机效应模型进行Meta分析。使用风险比总结二分结局,使用均值差异评估连续结局。
    文献检索确定了22项纳入分析的研究。SSC的相对风险(RR)显着降低(RR:0.568,P=0.003),手术部位感染(SSI)(RR:0.512,P<.001),浅表SSI(RR:0.373,P<.001),深SSI(RR:0.368,P=.033),开裂(RR:0.581,P=0.042)与ciNPT使用相关。ciNPT的使用还与再入院风险降低和住院时间减少2.6天相关(P<.001)。
    这些研究结果表明,在接受腹部开放手术的患者中使用ciNPT可以帮助减少SSC和相关的住院时间以及再次入院。该摘要的先前版本在米兰举行的2023年欧洲伤口管理协会(EWMA)会议上提出,意大利,并在下面列出的网站上在线发布。EWMA允许将摘要与完整的手稿一起重新出版。https://日记帐。cambridgegemedia.com.au/application/files/9116/8920/7316/JWM_Abstracts_LR.PDF。
    UNASSIGNED: Surgical site complications (SSCs) pose a significant risk to patients, potentially leading to severe consequences or even loss of life. While previous research has shown that closed incision negative pressure therapy (ciNPT) can reduce wound complications in various surgical fields, its effectiveness in abdominal incisions remains uncertain. To address this gap, a systematic review and meta-analysis were conducted to assess the impact of ciNPT on postsurgical outcomes and health care utilization in patients undergoing open abdominal surgeries.
    UNASSIGNED: A systematic literature search using PubMed, EMBASE, and QUOSA was performed for publications written in English, comparing ciNPT with standard of care dressings for patients undergoing abdominal surgical procedures between January 2005 and August 2021. Characteristics of study participants, surgical procedures, dressings used, duration of treatment, postsurgical outcomes, and follow-up data were extracted. Meta-analyses were performed using random-effects models. Dichotomous outcomes were summarized using risk ratios and continuous outcomes were assessed using mean differences.
    UNASSIGNED: The literature search identified 22 studies for inclusion in the analysis. Significant reductions in relative risk (RR) of SSC (RR: 0.568, P = .003), surgical site infection (SSI) (RR: 0.512, P < .001), superficial SSI (RR: 0.373, P < .001), deep SSI (RR: 0.368, P =.033), and dehiscence (RR: 0.581, P = .042) were associated with ciNPT use. ciNPT use was also associated with a reduced risk of readmission and a 2.6-day reduction in hospital length of stay (P < .001).
    UNASSIGNED: These findings indicate that use of ciNPT in patients undergoing open abdominal procedures can help reduce SSCs and associated hospital length of stay as well as readmissions.A previous version of this abstract was presented at the 2023 Conference of the European Wound Management Association (EWMA) in Milan, Italy and posted online at the site listed below. EWMA permits abstracts to be republished with the complete manuscript. https://journals.cambridgemedia.com.au/application/files/9116/8920/7316/JWM_Abstracts_LR.pdf.
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  • DOI:
    文章类型: Journal Article
    OBJECTIVE: The application of incisional negative pressure wound therapy (INPWT) to clean, closed surgical incisions is a growing clinical practice. A systematic review was conducted to evaluate the effect of INPWT on surgical sites healing by primary intention. The primary outcomes of interest are incidence of complications (infection, dehiscence, seroma, hematoma, skin necrosis, or blistering).
    METHODS: Two independent reviewers performed a search of the Ovid MEDLINE and EMBASE databases from 2006 to 2012 for published articles. Supplemental searches were performed using reference lists and conference proceedings. Studies were selected for inclusion based on predetermined inclusion and exclusion criteria. Data extraction regarding study quality, demographic and clinical characteristics, and outcomes was performed independently, and data on the incidence of infection was combined using a fixed-effects meta-analysis model.
    RESULTS: Ten (5 randomized controlled trials and 5 observational) studies were included, which investigated the outcomes of 626 incisions on 610 patients. Six studies compared INPWT with sterile dry dressings (SDDs). The literature shows a significant decrease in rates of infection when using INPWT. RESULTS on dehiscence do show a decrease in some studies, but results are inconsistent to make a conclusion. Because of limited studies, it is difficult to make any assertions on seroma, hematoma, and skin necrosis.
    CONCLUSIONS: This systematic review shows possible evidence of a decrease in the incidence of infection with application of INPWT. Looking at other variables such as dehiscence, seroma, hematoma, and skin necrosis show no consistent data and suggest further studies in order for proper recommendations for INPWT.
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