前臂闭合性骨折手术治疗患者一期切口负压创面治疗与常规手术敷料的疤痕质量比较:一项随机对照试验。

IF 2 3区 医学 Q2 SURGERY
M Sharran, Gopisankar Balaji, Sukruth Anand Patel, Bhawana Badhe
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引用次数: 0

摘要

背景:伤口愈合和疤痕质量是决定哪种敷料技术更好的关键因素。目的:本研究旨在确定闭合性前臂骨折最终固定后,切口负压创面治疗是否比常规敷料提供更好的疤痕质量。方法:对2022年4月至2024年1月诊断为急性闭合性前臂骨折并接受切开复位内固定的患者进行前瞻性随机对照试验。患者接受标准无菌敷料或切口负压伤口治疗(iNPWT)。主要结果是在12周时通过检查胶原成分来比较组织病理学瘢痕质量。次要结果包括手术部位感染评估(ASEPSIS评分)和使用患者和观察者疤痕评估量表进行临床疤痕评估。进行单变量logistic回归分析。结果:纳入34例患者,47%接受iNPWT治疗(n = 16), 53%接受标准敷料治疗(n = 18)。使用马松三色染色,干预组中15名参与者(93.7%)获得了良好的结果,未调整的相对危险度为1.13 (95% CI: 0.88-1.43, p = 0.341)。使用Reticulin染色,干预组中12名参与者(75%)表现出理想的结果,未调整的相对危险度为0.79 (95% CI: 0.58-1.07,p = 0.13)。干预组ASEPSIS评分平均为1.75,SD为2.11 [95% CI-0.62 ~ 2.87, p = 0.14]。两组患者平均疤痕评分的计算差异为7.31 (p = 0.003),观察者评分为4.5 (p = 0.043)。结论:接受iNPWT治疗的患者瘢痕外观满意,马氏三色染色组织病理学评估结果良好。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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 .

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来源期刊
CiteScore
4.40
自引率
25.00%
发文量
479
审稿时长
3 months
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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