闭合切口负压治疗在DIEP皮瓣乳房供区再造术中的临床应用。

IF 2.4 3区 医学 Q2 SURGERY
Giuseppe Angelo Giovanni Lombardo, Francesco Ciancio, Francesco Ruben Giardino, Alessio Stivala, Dario Melita, Paolo Marchica, Rosario Ranno, Domenico Marrella
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引用次数: 0

摘要

腹下深层穿支皮瓣乳房重建的供区伤口不同于腹部成形术,因为它的位置和张力更高,可能影响愈合。闭口负压治疗可改善创面愈合,减少并发症。本研究旨在评估该工具对供区伤口并发症和疤痕相关患者预后的影响。这项回顾性队列研究包括140名患者,他们在2020年9月至2023年3月期间接受了延迟的上腹部深下穿支皮瓣乳房重建。将患者分为A组(闭合切口负压治疗)和B组(微孔胶带敷料)。两组均接受标准化围手术期护理。分析并发症,并使用scar - q评估术后1年的疤痕。p≤0.05为差异有统计学意义。两组在基线特征上无显著差异。A组创面裂开明显低于B组(p = 0.0003)。两组间创面裂开后平均愈合时间相似(p = 0.270)。其他并发症,如感染或血肿,无显著差异。关于SCAR-Q, A组患者在症状量表上报告了明显更好的结果(p = 0.03),而在外观或心理社会影响方面没有观察到显著差异。闭合切口负压治疗降低了伤口裂开的发生率,但没有显著改善疤痕质量或其他并发症。鉴于有限的收益和缺乏成本效益数据,该工具应考虑进一步研究,而不是常规临床应用于低风险的上腹部深下穿支皮瓣患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical impact of closed-incision negative-pressure therapy in DIEP flap breast reconstruction's donor site.

The donor-site wound from deep inferior epigastric perforator flap breast reconstruction differs from abdominoplasty due to higher positioning and tension, potentially affecting healing. Closed-incision negative-pressure therapy has been proposed to improve wound healing and reduce complications. This study aimed to evaluate the impact of this tool on donor-site wound's complications and scar-related patient outcomes. This retrospective cohort study included 140 patients who underwent delayed deep inferior epigastric perforator flap breast reconstruction between September 2020 and March 2023. Patients were assigned to Group A (closed-incision negative-pressure therapy) or group B (micropore tape dressings). Both groups received standardized perioperative care. Complications were analyzed, and scar were assessed 1 year postoperatively using SCAR-Q. Statistical significance was set at p ≤ 0.05. There were no significant differences between the two groups in baseline characteristics. Wound dehiscence was significantly lower in Group A compared to Group B (p = 0.0003). The mean time to wound healing after dehiscence was similar between groups (p = 0.270). No significant differences were found in other complications, such as infection or hematoma. Concerning SCAR-Q, patients in Group A reported significantly better outcomes on the symptom scale (p = 0.03), whereas no significant differences were observed for appearance or psychosocial impact. Closed-incision negative-pressure therapy reduced the rate of wound dehiscence but did not significantly improve scar quality or other complications. Given the limited benefits and lack of cost-effectiveness data, this tool should be considered for further study rather than routine clinical use in low-risk deep inferior epigastric perforator flap patients.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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