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血管手术后腹股沟区血管周围感染性创面应用 VAC® 和 Sorbalgon® 治疗的临床转归和微血管血流:早期中期分析。

Clinical outcome and microvascular blood flow in VAC® - and Sorbalgon® -treated peri-vascular infected wounds in the groin after vascular surgery - an early interim analysis.

机构信息

Vascular Center Malmö-Lund, Malmö University Hospital, Malmö, Sweden.

出版信息

Int Wound J. 2013 Aug;10(4):377-82. doi: 10.1111/j.1742-481X.2012.00993.x. Epub 2012 Jun 4.

Abstract

Vacuum-assisted wound closure (VAC(®)) therapy is considered to be superior to conventional dressings in the treatment of peri-vascular groin infections after vascular surgery at our department. Therefore, we performed an early interim analysis of the clinical outcomes in these seriously ill patients at risk of amputation and death. Patients were randomised to either VAC(®) (n = 5) or Sorbalgon(®) (n = 5; best alternative treatment) therapy after surgical debridement. Non-invasive, laser Doppler perfusion imaging (LDPI) studies of the skin adjacent to the undressed wound were performed after 14 days of wound treatment. There was no difference in LDPI values in VAC(®) versus Sorbalgon(®) treated patients (P = 0·46). One patient in the VAC(®) group suffered from two re-bleeding episodes, leading to vascular resection and transfemoral amputation and in the Sorbalgon(®) group two had a complete wound healing time of more than 4 months and one had a visible interposition bypass graft in the groin after 1 month of treatment. No patient died of the groin infection. Although not statistically proven, fewer wound treatment failures were recorded in the VAC(®) group, justifying this early interim analysis. LDPI studies were feasible.

摘要

真空辅助伤口闭合(VAC(®))治疗被认为优于传统敷料,在我们科血管手术后治疗血管周围腹股沟感染。因此,我们对有截肢和死亡风险的这些重病患者的临床结果进行了早期中期分析。在手术清创后,患者被随机分配到 VAC(®)(n = 5)或 Sorbalgon(®)(n = 5;最佳替代治疗)治疗组。在伤口治疗 14 天后,对未包扎伤口附近的皮肤进行非侵入性、激光多普勒灌注成像(LDPI)研究。VAC(®)与 Sorbalgon(®)治疗患者的 LDPI 值无差异(P = 0.46)。VAC(®)组有 1 名患者发生 2 次再出血事件,导致血管切除和股动脉截肢,Sorbalgon(®)组有 2 名患者的完全伤口愈合时间超过 4 个月,1 名患者在治疗 1 个月后腹股沟处可见旁路移植血管。没有患者死于腹股沟感染。虽然没有统计学意义,但 VAC(®)组的伤口治疗失败记录较少,这证明了早期中期分析的合理性。LDPI 研究是可行的。

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