Negative pressure wound therapy for surgical site infections: A systematic review and meta‐analysis

医学 荟萃分析 负压伤口治疗 随机对照试验 优势比 不利影响 相对风险 置信区间 外科 手术伤口 梅德林 清创术(牙科) 系统回顾 手术部位感染 内科学 病理 法学 替代医学 政治学
作者
Junru Gao,Yunyun Wang,Jingyu Song,Ze Li,Jianan Ren,Peige Wang
出处
期刊:Journal of Advanced Nursing [Wiley]
卷期号:77 (10): 3980-3990 被引量:45
标识
DOI:10.1111/jan.14876
摘要

Abstract Objective Negative pressure wound therapy is one of the most common treatments for infected wounds. The aim of this meta‐analysis was to compare the efficacy of negative pressure wound therapy with conventional treatment methods in the treatment of surgical site infection. Design This study is registered with International Prospective Register of Systematic Reviews. Data Sources The Pubmed, Embase and the Cochrane Central Register of Controlled Trials databases were searched. Methods The systematic review was searched by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses method. All trials reporting the use of negative pressure wound therapy for surgical site infection treatment were included regardless of surgery type. The primary outcome measure was wound healing. Secondary outcomes were length of hospital stay, medical costs, adverse events, and reoperation rates. Results are presented with 95% confidence intervals and report estimates as odds ratios. Heterogeneity was determined through the I 2 test, with I 2 > 50% indicating substantial heterogeneity and p < .10 significance. The search was performed on 10 March 2020. Results We identified 13 eligible trial comparisons, of which 2 were randomized controlled trials and 11 cohort study. Negative pressure wound therapy in surgical site infection (SSI) patients significantly increased wound healing rate, accelerated wound healing time, increased daily wound healing area, reduced hospital stay, and reduced adverse events. However, negative pressure wound therapy was associated with increased medical costs. Conclusion Negative pressure wound therapy may be more effective for the treatment of surgical site infection relative to conventional debridement, dressings and other treatments. However, further high‐quality randomized controlled trials are needed to determine the most optimal application of negative pressure wound therapy. Impact. Negative pressure wound therapy is the best treatment strategy for surgical site infection. This study can improve medical practitioners’ awareness of negative pressure wound therapy for surgical site infection, promoting the development of relevant randomized controlled trials.
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