随着人口老龄化和越来越多的肥胖和/或接受晚期癌症治疗的人,包括手术部位感染(SSIs)在内的手术部位并发症的风险增加.大型动员组织瓣的术后移位,比如在腹部成形术中,仍然是一个可怕的并发症,特别是在大量减肥之后。除了对病人的负面影响,手术部位并发症由于长时间和重复的伤口治疗而导致经济负担。需要减少SSI的预防性工具。在选定的具有高SSI和/或伤口破裂风险的患者中,切口NPWT的使用已被证明可以积极地管理清洁,闭合手术切口。本文包含与手术切口使用NPWT相关的科学和临床研究的综述,特别强调减肥后患者进行身体轮廓手术后伤口破裂和SSI的常见问题。尽管越来越多的研究描述了在各种应用中使用切口NPWT,包括血管,心脏和骨科,文献检索显示,很少有关于切口NPWT在身体轮廓手术后使用的研究。在血清肿形成的临床研究中,据报道,接受切口NPWT的减肥后患者的血清肿和血肿形成较少,相对于控件,身体轮廓手术后。在另一项研究中,在减重腹部皮脂切除术后腹侧干和外侧干广泛使用外部NPWT伤口敷料,结果显示渗出物形成显著减少,较早拆卸排水口,住院时间缩短,与常规治疗相比。需要更多的对照研究来验证身体轮廓手术后切口NPWT的临床影响。并确定其使用的适当建议。
With an ageing population and a growing number of people with obesity and/or undergoing advanced cancer therapies, there is an increasing risk of surgical site complications including surgical site infections (SSIs). Postoperative shifting of large mobilised tissue flaps, such as in abdominoplasties, remains a dreaded complication, particularly following massive weight loss. Besides negative implications for the patient, surgical site complications result in an economic burden due to prolonged and repeated wound treatments. Preventative tools to reduce SSIs are needed. In selected patients at high risk of SSI and/or wound breakdown, use of incisional NPWT has been shown to actively manage clean, closed surgical incisions. This article contains a review of scientific and clinical research relevant to incisional NPWT use over surgical incisions, with particular emphasis on the common problem of wound breakdown and SSI following body-contouring surgery in post-bariatric patients. Although there are a growing number of studies describing use of incisional NPWT in a variety of applications, including vascular, cardiac and orthopaedic, a literature search revealed few studies regarding incisional NPWT use post body-contouring surgery. In a clinical study of seroma formation, less seroma and haematoma formation was reported in post-bariatric patients who received incisional NPWT, versus the control, following body-contouring surgery. In another study of widely applied external NPWT wound dressings over the ventral and lateral trunk following post-bariatric abdominal dermolipectomy, results showed a significant reduction in exudate formation, earlier drain removal, and decreased length of hospitalisation, compared with conventional treatment. Additional controlled studies are needed to validate the clinical impact of incisional NPWT following body-contouring surgery, and to determine proper recommendations for its use.