伤口清创的水手术:系统综述

Rafael Bolaos-Daz, F. Alfaro
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引用次数: 1

摘要

水手术系统(Versajet®)已经应用了20多年,它的作用是基于文丘里效应的原理,即产生一种薄的切向流体(切向水射流),并以高速推进,主要在无活力的组织上产生切除。目的:探讨水手术在急慢性创面清创中的有效性和安全性。结果:根据AMSTAR标准选择了5个系统评价(SRs),并排除了2个SRs。Kakagia等选取了20篇文章,其中3篇为随机临床试验(rct)。两项随机对照试验仅包括烧伤,1项随机对照试验包括一般急性损伤。Edmondson等人回顾了各种烧伤清创技术的证据。他试图确定手术刀切除是否仍然是比较的标准。他选择了18项研究,其中3项为随机对照试验。Bekara等选取了7项关于水手术的研究,其中只有2项是随机对照试验。Kwa等比较了手术和非手术烧伤技术,纳入了8项水手术研究,其中2项为随机对照试验。Elraiyah等人回顾了有关糖尿病足溃疡技术的证据。他选择了1个有水手术的RCT。结论:水手术似乎减少了清创的次数,并有利于更好地保存下层真皮和在困难轮廓水平上的清创精度。证据仍然稀少,统计效力低,研究设计中存在中等偏倚风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hydrosurgery for Wound Debridement: Overview of Systematic Reviews
Hydrosurgery system (Versajet®) has been applied for more than 20 years and exerts its action based on the principle of the Venturi effect, in which a thin and cutting tangential fluid (tangential hydrojet) is generated and is propelled at high speed generating excision mainly on non-viable tissue. Objective: To determine the effectiveness and safety regarding the use of hydrosurgery in the debridement of acute or chronic wounds. Findings: Five systematic reviews (SRs) were selected according to the AMSTAR criteria and 2 SRs were excluded. Kakagia et al selected 20 articles, of which 3 were randomized clinical trials (RCTs). Two were RCTs that exclusively included burn injuries and 1 RCT included acute injuries in general. Edmondson et al reviewed the evidence for various burn debridement techniques. He sought to determine if scalpel excision should remain the standard of comparison. He selected 18 studies, of which 3 were RCTs. Bekara et al selected 7 studies for hydrosurgery and only 2 were RCTs. Kwa et al compared surgical and non-surgical burn techniques and included 8 studies with hydrosurgery, of which 2 were RCTs. Elraiyah et al reviewed the evidence regarding techniques for diabetic foot ulcers. He selected 1 RCT with hydrosurgery. Conclusion: Hydrosurgery seems to reduce the number of debridements as well as favor a greater preservation of the underlying dermis and precision of debridement at the level of difficult contours. The evidence is still scarce and of low statistical power with moderate risk of bias in the study designs.
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