背景:在伴有软组织缺损的慢性骨髓炎(COSTD)中,3D打印假体植入后的皮瓣闭合切口愈合至关重要。本研究旨在探讨负压创面治疗(NPWT)促进皮瓣闭合切口愈合的安全性和有效性。
方法:对临床资料进行回顾性分析,包括基线,手术和住院信息。通过比较ASEPSIS评分来评估NPWT的疗效,视觉模拟量表(VAS),日常生活活动量表(ADLS),和下肢功能量表(LEFS),以及术后的主要并发症。
结果:该研究包括20名患者,13例接受常规敷料(对照组),7例接受NPWT治疗(NPWT组)。这两组在ASEPSIS分数的分布上表现出明显的差异,对照组和NPWT组的中位数评分分别为24和9(p=0.001)。对照组有8例患者出现严重的切口并发症,包括7例渗出,3例感染,2例不愈合,和1例开裂,而在NPWT组中没有观察到(p=0.015)。VAS,广告,与对照组相比,NPWT组的LEFS和LEFS评分显着改善(分别为p=0.003、0.017和0.043)。
结论:研究结果表明,NPWT应用于COSTD患者3D假体植入后皮瓣闭合切口愈合过程中,可减少术后主要并发症的发生,促进下肢功能和日常活动的恢复。应推荐用于临床实践。
BACKGROUND: The flap closed-incisions healing after 3D-printed prosthesis implantation in Chronic Osteomyelitis with Soft Tissue Defects (COSTD) is critical. This study aimed to explore the safety and effectiveness of Negative Pressure Wound Therapy (NPWT) in promoting flap closed-incisions healing.
METHODS: Retrospective analysis of clinical data was performed, including baseline, surgical and hospitalization information. The efficacy of NPWT was assessed by comparing the ASEPSIS scores, Visual Analogue Scale (VAS), Activity of Daily Living Scale (ADLS), and Lower Extremity Functional Scale (LEFS), as well as the major postoperative complications.
RESULTS: The study included 20 patients, 13 received conventional dressing (Control group) and 7 received NPWT treatment (NPWT group). These two groups exhibited a notable disparity in the distribution of ASEPSIS scores, and the median scores were 24 in Control group and 9 in NPWT group (p = 0.001). Eight patients in the Control group experienced major incisional complications, including 7 cases of exudation, 3 cases of infection, 2 cases of non-healing, and 1 case of dehiscence, while none were observed in the NPWT group (p = 0.015). The VAS, ADLS, and LEFS scores were significantly improved in the NPWT group compared to the Control group (p = 0.003, 0.017, and 0.043, respectively).
CONCLUSIONS: The study findings suggest that NPWT applied to the healing process of flap closed-incisions after 3D prosthesis implantation in patients with COSTD can reduce the occurrence of postoperative major complications and promote the recovery of lower limb function and daily activities, which should be recommended for clinical practice.