Comparison of Scar Quality Between Primary Incisional Negative Pressure Wound Therapy and Conventional Surgical Dressing in Patients with Closed Forearm Fractures Treated Surgically: A Randomised Controlled Trial.
M Sharran, Gopisankar Balaji, Sukruth Anand Patel, Bhawana Badhe
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引用次数: 0
Abstract
Background: Wound healing and the quality of the scar plays a key role in deciding which dressing technique is better.
Objective: The study aimed to determine if primary incisional negative pressure wound therapy provides better scar quality compared to conventional dressing following definitive fixation of closed forearm fractures.
Methods: A prospective randomized control trial of patients diagnosed with acute closed forearm fractures who underwent open reduction and internal fixation from April 2022 to January 2024. Patients received either a standard sterile dressing or incisional negative pressure wound therapy (iNPWT). The primary outcome was comparing the histopathological scar quality by examining collagen composition at 12 weeks. Secondary outcomes included assessment of surgical site infection (ASEPSIS Score) and clinical scar assessment using the Patient and Observer Scar Assessment Scale. Univariate logistic regression analyses were performed.
Results: 34 patients were included, 47% received iNPWT (n = 16), and 53% received standard dressings (n = 18). With Masson's trichrome stain,15 participants (93.7%) in the intervention group experienced a favourable outcome with an unadjusted relative risk of 1.13 (95% CI: 0.88-1.43, p = 0.341). With Reticulin stain, 12 participants (75%) in the intervention group exhibited desirable results with an unadjusted relative risk of 0.79 (95% CI: 0.58-1.07,p = 0.13). The intervention group had a mean ASEPSIS score of 1.75 with an SD of 2.11 [95% CI-0.62 to 2.87, p = 0.14]. The calculated difference in mean Patient scar scores between the two groups was 7.31 (p = 0.003), and the observer score was 4.5 (p = 0.043).
Conclusions: Patients who underwent iNPWT showed cosmetic satisfaction of scar and favourable outcomes in histopathological assessment with Masson's trichrome stain.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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