The use of negative pressure wound therapy following stoma reversal: a systematic review and meta-analysis of randomized controlled trials.

IF 2.3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-03-20 DOI:10.1007/s00384-025-04865-2

Caroline Drumm, Ben Creavin, Iva Pranjic Previsic, Maeve O'Neill, John Larkin, Brian J Mehigan, Dara Kavanagh, Paul McCormick, Michael Eamon Kelly

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引用次数: 0

Abstract

Introduction: Stoma reversal is a contaminated surgery with many patients experiencing significant wound complications that contribute to patient morbidity. It is believed that the use of prophylactic negative pressure wound therapy (NPWT) may enhance wound healing and help reduce the risk of developing surgical site infections (SSI). However, there is conflicting research regarding its effectiveness following stoma reversal. Our systematic review aims to evaluate the available randomized data to determine if the use of prophylactic NPWT after stoma reversal improves the duration of wound healing and reduces rates of postoperative complications.

Methods: A comprehensive search of literature published up to January 2025 was conducted using the following databases: PubMed, Embase, Medline, and Cochrane Library. The included trials were randomized controlled trials that investigated the effect of NPWT following stoma reversal. The primary outcome was the time to complete wound healing. Secondary outcomes included the incidence of wound complications, SSI, hematomas, and the length of hospital stay.

Results: Six randomised control trials were included, with 332 patients, of which 171 of these underwent NPWT. There was a significant reduction in time to complete wound healing (OR - 2.53, 95% CI - 3.82 to - 1.24, p = 0.0001, I² = 45%) and wound healing at 42 days (OR 0.36, 95% CI 0.14 - 0.88, p = 0.03, I² = 0%) in the NPWT group. There was no significant difference in any wound complications (OR 0.72, 95% CI 0.23-2.28, p = 0.58, I² = 42%), SSI rates (OR 0.95, 95% CI 0.27-3.29, p = 0.94, I² = 38%) or haematoma rates (OR 0.21, 95% CI 0.03-1.27, p = 0.09, I² = 0%) between the groups. There was no significant difference in length of stay (OR - 0.02, 95% CI - 1.21-1.18, p = 0.98, I² = 66%).

Conclusion: The use of NPWT after stoma reversal significantly reduces the time needed for complete wound healing while maintaining a comparable rate of wound complications and length of hospital stay. Therefore, NPWT may be valuable in optimizing postoperative recovery and enhancing patient outcomes.

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造口逆转后负压伤口治疗的使用：随机对照试验的系统回顾和荟萃分析。

简介：造口逆转是一种污染手术，许多患者经历了严重的伤口并发症，导致患者发病率。人们认为，使用预防性负压伤口治疗（NPWT）可以促进伤口愈合，并有助于降低发生手术部位感染（SSI）的风险。然而，关于其在造口逆转后的有效性，有相互矛盾的研究。我们的系统综述旨在评估现有的随机数据，以确定在造口逆转后使用预防性NPWT是否能改善伤口愈合时间并降低术后并发症的发生率。方法：使用PubMed、Embase、Medline和Cochrane Library数据库对截至2025年1月发表的文献进行全面检索。纳入的试验是随机对照试验，研究了造口逆转后NPWT的影响。主要观察指标为伤口完全愈合的时间。次要结局包括伤口并发症、SSI、血肿和住院时间的发生率。结果：纳入6项随机对照试验，332例患者，其中171例患者接受了NPWT。NPWT组伤口愈合时间显著缩短（OR - 2.53, 95% CI - 3.82至- 1.24,p = 0.0001, I2 = 45%）， 42天伤口愈合时间显著缩短（OR 0.36, 95% CI 0.14 - 0.88, p = 0.03, I2 = 0%）。两组间伤口并发症（OR 0.72, 95% CI 0.23-2.28, p = 0.58, I2 = 42%）、SSI发生率（OR 0.95, 95% CI 0.27-3.29, p = 0.94, I2 = 38%）和血肿发生率（OR 0.21, 95% CI 0.03-1.27, p = 0.09, I2 = 0%）均无显著差异。两组住院时间差异无统计学意义（OR - 0.02, 95% CI - 1.21-1.18, p = 0.98, I2 = 66%）。结论：造口逆转后使用NPWT可显著减少创面完全愈合所需的时间，同时保持相当的创面并发症发生率和住院时间。因此，NPWT在优化术后恢复和提高患者预后方面可能有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.