与传统敷料相比,预防性闭合切口负压伤口治疗在预防髋关节和膝关节翻修术后假体周围关节感染方面的有效性:一项系统综述。

IF 1.5 Q3 NURSING
Tracy Morgan , Tamara Page
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引用次数: 0

摘要

目的:评价预防性闭合切口负压伤口治疗(ciNPWT)与传统敷料在预防髋关节和膝关节翻修术后假体周围关节感染(PJI)方面的有效性。方法:检索5个数据库(MEDLINE、Embase.、Emare、CINAHL和Scopus),没有日期或语言限制。两名独立评审员根据3项纳入研究的纳入标准和方法学质量对文章进行了评估。使用定制的数据工具提取数据,包括干预措施、研究方法和感兴趣的结果。进行了荟萃分析,结果以森林情节的叙述形式呈现。研究结果:这三项研究,一项随机对照试验和两项准实验研究,包括136名干预参与者和228名对照参与者(样本364)。与保守敷料队列相比,ciNPWT队列的PJI发生率降低(2[1.47%]vs 27[11.84%])。与传统敷料队列相比(4[2.94%]vs 35[15.35%]),ciNPWT队列的再次手术率较低。与传统包扎队列相比(14[10.29%]vs 85[37.28),ciNPWT队列的伤口并发症发生率显著降低结论:预防性应用ciNPWT可有效减少髋关节和膝关节翻修术后的伤口并发症、PJI和再次手术。ciNPWT的增加成本可能在减少伤口并发症、PJI和再次手术方面是合理的。正在进行的试验确定在髋关节和膝关节翻修术后预防性应用ciNPWT是否有利于预防PJI,特别是在有其他合并症的高危患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effectiveness of prophylactic closed incision negative pressure wound therapy compared to conventional dressings in the prevention of periprosthetic joint infection post hip and knee revision arthroplasty surgery: A systematic review

Objective

To evaluate the effectiveness of prophylactic closed incision negative pressure wound therapy (ciNPWT) compared to conventional dressings in the prevention of periprosthetic joint infection (PJI) post hip and knee revision arthroplasty surgery.

Method

Five databases (MEDLINE, Embase., Emcare, CINAHL and Scopus) were searched with no date or language limits. Two independent reviewers assessed articles against the inclusion criteria and methodological quality of the 3 included studies. Data was extracted using a customised data tool and included the intervention, study methods and outcomes of interest. A meta-analysis was performed, and results presented in narrative form with forest plots.

Findings

The three studies, one randomized control trial and two quasi-experimental studies, included 136 intervention and 228 control participants (Sample 364). The PJI rate decreased in the ciNPWT cohort compared to the conservative dressing cohort (2 [1.47%] vs 27 [11.84%]). The reoperation rate was lower in the ciNPWT cohort versus the conventional cohort (4 [2.94%] vs 35 [15.35%]). The rate of wound complications was significantly decreased in the ciNPWT cohort compared to the conventional dressing cohort (14 [10.29%] v 85 [37.28), p=<0.001).

Conclusion

Prophylactic application of ciNPWT may be effective in reducing wound complications, PJI and reoperation post hip and knee revision arthroplasty surgery. The added cost of ciNPWT may be justified in the reduction of wound complications, PJI and reoperation. Ongoing trials determining if the prophylactic application of ciNPWT post hip and knee revision arthroplasty surgery is beneficial in preventing PJI particularly in high risk patients with additional comorbidities are warranted.

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来源期刊
CiteScore
2.60
自引率
14.30%
发文量
34
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