Evidence-based recommendations for negative pressure wound therapy: Treatment variables (pressure levels, wound filler and contact layer) - Steps towards an international consensus

被引：138

作者：

Birke-Sorensen, H. ^{[3
]}

Malmsjo, M. ^{[4
,5
]}

Rome, P. ^{[6
,7
]}

Hudson, D. ^{[8
]}

Krug, E. ^{[9
]}

Berg, L. ^{[10
]}

Bruhin, A. ^{[11
]}

Caravaggi, C. ^{[12
]}

Chariker, M. ^{[13
]}

Depoorter, M. ^{[14
]}

Dowsett, C. ^{[15
]}

Dunn, R. ^{[16
,17
]}

Duteille, F. ^{[18
]}

Ferreira, F. ^{[19
]}

Francos Martinez, J. M. ^{[20
]}

Grudzien, G. ^{[21
]}

Ichioka, S. ^{[22
]}

Ingemansson, R. ^{[23
]}

Jeffery, S. ^{[24
]}

Lee, C. ^{[25
,26
]}

Vig, S. ^{[27
]}

Runkel, N. ^{[1
,2
]}

Martin, R.

Smith, J.

机构：

[1] Black Forest Hosp, Dept Gen Surg, Villingen, Germany

[2] Univ Freiburg, D-7800 Freiburg, Germany

[3] Hamlet Hosp, Aarhus, Denmark

[4] Lund Univ, Dept Ophthalmol, Lund, Sweden

[5] Skane Univ Hosp, Lund, Sweden

[6] Royal Prince Alfred Hosp, Sydney, NSW, Australia

[7] Concord Hosp, Sydney, NSW, Australia

[8] Groote Schuur Hosp, Dept Plast & Reconstruct Surg, ZA-7925 Cape Town, South Africa

[9] Leiden Univ, Med Ctr, NL-2300 RA Leiden, Netherlands

[10] Kuopio Univ Hosp, Kuopio, Finland

[11] Dept Trauma & Visceral Surg, Luzern, Switzerland

[12] Inst Clin Citta Studi Milan, Ctr Treatment Diabet Foot Pathol, Milan, Italy

[13] Aesthet Plast Surg Inst, Louisville, KY USA

[14] Acad Hosp St Jan, Dept Plast & Reconstruct Surg, Brugge, Belgium

[15] E London NHS Fdn Trust, Community Hlth Newham Directorate, London, England

[16] Univ Massachusetts, Sch Med, Div Plast Surg, Worcester, MA 01605 USA

[17] Mem Hlth Care, Worcester, MA USA

[18] Hop Hotel Dieu, Plast Aesthet & Reconstruct Surg Burn Unit, Nantes, France

[19] Hosp Pedro Hispano, Matosinhos Porto, Portugal

[20] Hosp Univ Bellvitge, Endocrine Surg Unit, Barcelona, Spain

[21] John Paul 2 Hosp, Dept Cardiovasc Surg & Transplantol, Krakow, Poland

[22] Saitama Med Univ, Dept Plast & Reconstruct Surg, Saitama, Japan

[23] Univ Lund Hosp, Dept Cardiothorac Surg, Heart & Lung Div, Lund, Sweden

[24] Queen Elizabeth Hosp, Royal Ctr Def Med, Birmingham B15 2TH, W Midlands, England

[25] Univ Calif San Francisco, San Francisco, CA 94143 USA

[26] St Marys Hosp, San Francisco, CA USA

[27] Mayday Univ Hosp, London, England

来源：

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY | 2011年 / 64卷

关键词：

Negative pressure wound therapy (NPWT); Recommendations; Systematic review; Consensus; NPWT wound-filler materials; Negative pressure level; VACUUM-ASSISTED CLOSURE; PERISTERNAL THORACIC WALL; MICROVASCULAR BLOOD-FLOW; SECURING SKIN-GRAFTS; SUBATMOSPHERIC PRESSURE; BACTERIAL BIOBURDEN; COST-EFFECTIVENESS; RANDOMIZED-TRIAL; DRESSING CHANGES; INFECTED WOUNDS;

D O I：

10.1016/j.bjps.2011.06.001

中图分类号：

R61 [外科手术学];

学科分类号：

100210 [外科学];

摘要：

Negative pressure wound therapy (NPWT) is becoming a commonplace treatment in many clinical settings. New devices and dressings are being introduced. Despite widespread adoption, there remains uncertainty regarding several aspects of NPWT use. To respond to these gaps, a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In a previous communication, we have reviewed the evidence base for the use of NPWT within trauma and reconstructive surgery. In this communication, we present results of the assessment of evidence relating to the different NPWT treatment variables: different wound fillers (principally foam and gauze); when to use a wound contact layer; different pressure settings; and the impact of NPWT on bacterial bioburden. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence and drafting of the recommendations by a global expert panel. Evidence and recommendations were graded according to the Scottish Intercollegiate Guidelines Network (SIGN) classification system. In general, there is relatively weak evidence on which to base recommendations for any one NPWT treatment variable over another. Overall, 14 recommendations were developed: five for the choice of wound filler and wound contact layer, four for choice of pressure setting and five for use of NPWT in infected wounds. With respect to bioburden, evidence suggests that reduction of bacteria in wounds is not a major mode of action of NPWT. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

引用

页码：S1 / S16

页数：16

共 122 条

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