JAMA:预防性负压伤口治疗不能降低肥胖剖宫产产妇术后感染风险

2020-09-23 MedSci原创 MedSci原创

对于接受剖宫产手术的肥胖产妇中,与标准伤口敷料相比,预防性负压伤口治疗并没有显著降低手术部位感染的风险

肥胖会增加产妇剖宫产和手术部位感染的风险。近日研究人员考察了剖宫产术后立即进行预防性负压伤口治疗对肥胖产妇手术部位感染风险的影响。

研究在美国开展,1624名计划或非计划剖宫产的肥胖产妇参与,在剖宫产后,随机接受预防性负压伤口治疗,在手术切口缝合后立即使用负压装置(n=816),或标准伤口敷料(n=808)。研究的主要结果是浅表或深部手术部位感染。次要结果包括其他伤口并发症、外科部位感染、其他伤口并发综合征以及皮肤不良反应。

参与者平均年龄30.4岁,平均体重指数39.5,1608名(99%)完成了研究。负压组29例(3.6%)和标准敷料组27例(3.4%)被诊断为浅表或深部手术部位感染(差异,0.36%)。在30个预先指定的次要终点中,有25个没有显著差异,包括其他伤口并发症(2.6% vs 3.1%;差异,-0.53%)以及外科部位感染及其他伤口并发症的综合征(6.5% vs 6.7%;差异-0.27%)。负压组皮肤不良反应发生率明显高于对照组(7.0% vs 0.6%;差异6.95%)。

研究认为,对于接受剖宫产手术的肥胖产妇中,与标准伤口敷料相比,预防性负压伤口治疗并没有显著降低手术部位感染的风险。

原始出处

Methodius G. Tuuli et al.Effect of Prophylactic Negative Pressure Wound Therapy vs Standard Wound Dressing on Surgical-Site Infection in Obese Women After Cesarean Delivery A Randomized Clinical Trial.JAMA. September 9, 2020.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1247596, encodeId=7780124e5965a, content=<a href='/topic/show?id=ede21046e996' target=_blank style='color:#2F92EE;'>#预防性负压伤口#</a>治疗不能降低<a href='/topic/show?id=3ad9818917c' target=_blank style='color:#2F92EE;'>#肥胖#</a><a href='/topic/show?id=a22e32e0212' target=_blank style='color:#2F92EE;'>#剖宫产#</a>产妇术后<a href='/topic/show?id=cfd353291f3' target=_blank style='color:#2F92EE;'>#感染#</a>风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104679, encryptionId=ede21046e996, topicName=预防性负压伤口), TopicDto(id=81891, encryptionId=3ad9818917c, topicName=肥胖), TopicDto(id=32702, encryptionId=a22e32e0212, topicName=剖宫产), TopicDto(id=53291, encryptionId=cfd353291f3, topicName=感染)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Wed Sep 07 03:13:22 CST 2022, time=2022-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887838, encodeId=2ed688e838e5, content=原始出处错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b972455532, createdName=1240394fm61暂无昵称, createdTime=Thu Sep 24 08:34:52 CST 2020, time=2020-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2034839, encodeId=ab862034839e9, content=<a href='/topic/show?id=69c910030635' target=_blank style='color:#2F92EE;'>#预防性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100306, encryptionId=69c910030635, topicName=预防性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Sat Jul 03 15:12:35 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899299, encodeId=ea5b8992999c, content=肥胖,减轻病人负担, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200620/aa639dfc8a1a4edf8fd1a054e00988dd/d30946ee96694a4f8aa034f2e536c052.jpg, createdBy=23f62697515, createdName=ms5000001417824766, createdTime=Sun Nov 15 12:53:59 CST 2020, time=2020-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887765, encodeId=4fab88e765df, content=参考文献错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Sep 23 21:22:19 CST 2020, time=2020-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036284, encodeId=894c103628420, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Sep 23 21:12:35 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
    2022-09-07 小小医者

    #预防性负压伤口#治疗不能降低#肥胖##剖宫产#产妇术后#感染#风险

    0

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    2020-09-24 1240394fm61暂无昵称

    原始出处错误

    1

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    2020-11-15 ms5000001417824766

    肥胖,减轻病人负担

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1247596, encodeId=7780124e5965a, content=<a href='/topic/show?id=ede21046e996' target=_blank style='color:#2F92EE;'>#预防性负压伤口#</a>治疗不能降低<a href='/topic/show?id=3ad9818917c' target=_blank style='color:#2F92EE;'>#肥胖#</a><a href='/topic/show?id=a22e32e0212' target=_blank style='color:#2F92EE;'>#剖宫产#</a>产妇术后<a href='/topic/show?id=cfd353291f3' target=_blank style='color:#2F92EE;'>#感染#</a>风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104679, encryptionId=ede21046e996, topicName=预防性负压伤口), TopicDto(id=81891, encryptionId=3ad9818917c, topicName=肥胖), TopicDto(id=32702, encryptionId=a22e32e0212, topicName=剖宫产), TopicDto(id=53291, encryptionId=cfd353291f3, topicName=感染)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Wed Sep 07 03:13:22 CST 2022, time=2022-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887838, encodeId=2ed688e838e5, content=原始出处错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b972455532, createdName=1240394fm61暂无昵称, createdTime=Thu Sep 24 08:34:52 CST 2020, time=2020-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2034839, encodeId=ab862034839e9, content=<a href='/topic/show?id=69c910030635' target=_blank style='color:#2F92EE;'>#预防性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100306, encryptionId=69c910030635, topicName=预防性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Sat Jul 03 15:12:35 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899299, encodeId=ea5b8992999c, content=肥胖,减轻病人负担, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200620/aa639dfc8a1a4edf8fd1a054e00988dd/d30946ee96694a4f8aa034f2e536c052.jpg, createdBy=23f62697515, createdName=ms5000001417824766, createdTime=Sun Nov 15 12:53:59 CST 2020, time=2020-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887765, encodeId=4fab88e765df, content=参考文献错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Sep 23 21:22:19 CST 2020, time=2020-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036284, encodeId=894c103628420, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Sep 23 21:12:35 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
    2020-09-23 lovetcm

    参考文献错误

    1

    展开1条回复
  6. [GetPortalCommentsPageByObjectIdResponse(id=1247596, encodeId=7780124e5965a, content=<a href='/topic/show?id=ede21046e996' target=_blank style='color:#2F92EE;'>#预防性负压伤口#</a>治疗不能降低<a href='/topic/show?id=3ad9818917c' target=_blank style='color:#2F92EE;'>#肥胖#</a><a href='/topic/show?id=a22e32e0212' target=_blank style='color:#2F92EE;'>#剖宫产#</a>产妇术后<a href='/topic/show?id=cfd353291f3' target=_blank style='color:#2F92EE;'>#感染#</a>风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104679, encryptionId=ede21046e996, topicName=预防性负压伤口), TopicDto(id=81891, encryptionId=3ad9818917c, topicName=肥胖), TopicDto(id=32702, encryptionId=a22e32e0212, topicName=剖宫产), TopicDto(id=53291, encryptionId=cfd353291f3, topicName=感染)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Wed Sep 07 03:13:22 CST 2022, time=2022-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887838, encodeId=2ed688e838e5, content=原始出处错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b972455532, createdName=1240394fm61暂无昵称, createdTime=Thu Sep 24 08:34:52 CST 2020, time=2020-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2034839, encodeId=ab862034839e9, content=<a href='/topic/show?id=69c910030635' target=_blank style='color:#2F92EE;'>#预防性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100306, encryptionId=69c910030635, topicName=预防性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Sat Jul 03 15:12:35 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899299, encodeId=ea5b8992999c, content=肥胖,减轻病人负担, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200620/aa639dfc8a1a4edf8fd1a054e00988dd/d30946ee96694a4f8aa034f2e536c052.jpg, createdBy=23f62697515, createdName=ms5000001417824766, createdTime=Sun Nov 15 12:53:59 CST 2020, time=2020-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887765, encodeId=4fab88e765df, content=参考文献错误, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Sep 23 21:22:19 CST 2020, time=2020-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036284, encodeId=894c103628420, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Sep 23 21:12:35 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
    2020-09-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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