Bilayered negative-pressure wound therapy preventing leg incision morbidity in coronary artery bypass graft patients
Identifieur interne : 000750 ( Main/Exploration ); précédent : 000749; suivant : 000751Bilayered negative-pressure wound therapy preventing leg incision morbidity in coronary artery bypass graft patients
Auteurs : Yongchao Yu ; Zhigang Song ; Zhiyun Xu ; Xiaofei Ye ; Chunyu Xue [République populaire de Chine] ; Junhui Li [République populaire de Chine] ; Hongda Bi [République populaire de Chine]Source :
- Medicine [ 0025-7974 ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- methods : Negative-Pressure Wound Therapy.
- prevention & control : Postoperative Complications.
- transplantation : Saphenous Vein.
- Adult, Aged, Coronary Artery Bypass, Female, Humans, Male, Middle Aged, Pilot Projects.
Abstract
The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial.
A single-center, pilot randomized controlled trial was conducted. From December 2013 to March 2014, a total of 72 coronary heart disease patients (48 men and 24 women) received CABG therapy, with great saphenous veins were selected as grafts. Patients were equally randomized into a treatment and a control group. After the harvesting of the great saphenous veins and direct closure of the wound with sutures, b-NPWT was used for the thigh incision in the treatment group for 5 days (treatment thigh). Traditional surgical pads were applied to both the shank incisions of the treatment group patients (treatment shank) and the entire incisions of the control group (control thigh, control shank). Postoperative complications were recorded and statistically analyzed based on outcomes of thigh treatment, shank treatment, thigh control, and shank control groups.
The incidence rates of early complications, such as lymphorrhagia, lymphoedema, infection, wound dehiscence, and skin flap necrosis, of the vascular donor site in the thigh treatment group was significantly lower than those in the 3 other groups.
The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting.
ClinicalTrials.gov. The unique registration number is NCT02010996.
Url:
DOI: 10.1097/MD.0000000000005925
PubMed: 28099357
PubMed Central: 5279102
Affiliations:
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last="Song">Zhigang Song</name><affiliation><nlm:aff id="aff1">Department of Cardiac Surgery</nlm:aff></affiliation></author><author><name sortKey="Xu, Zhiyun" sort="Xu, Zhiyun" uniqKey="Xu Z" first="Zhiyun" last="Xu">Zhiyun Xu</name><affiliation><nlm:aff id="aff1">Department of Cardiac Surgery</nlm:aff></affiliation></author><author><name sortKey="Ye, Xiaofei" sort="Ye, Xiaofei" uniqKey="Ye X" first="Xiaofei" last="Ye">Xiaofei Ye</name><affiliation><nlm:aff id="aff2">Department of Statistics, Faculty of Medical Services</nlm:aff><wicri:noCountry code="subfield">Faculty of Medical Services</wicri:noCountry></affiliation></author><author><name sortKey="Xue, Chunyu" sort="Xue, Chunyu" uniqKey="Xue C" first="Chunyu" last="Xue">Chunyu Xue</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.</nlm:aff><country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country><wicri:regionArea>Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433</wicri:regionArea><wicri:noRegion>Shanghai 200433</wicri:noRegion></affiliation></author><author><name sortKey="Li, Junhui" sort="Li, Junhui" uniqKey="Li J" first="Junhui" last="Li">Junhui Li</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.</nlm:aff><country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country><wicri:regionArea>Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433</wicri:regionArea><wicri:noRegion>Shanghai 200433</wicri:noRegion></affiliation></author><author><name sortKey="Bi, Hongda" sort="Bi, Hongda" uniqKey="Bi H" first="Hongda" last="Bi">Hongda Bi</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.</nlm:aff><country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country><wicri:regionArea>Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433</wicri:regionArea><wicri:noRegion>Shanghai 200433</wicri:noRegion></affiliation></author></analytic><series><title level="j">Medicine</title><idno type="ISSN">0025-7974</idno><idno type="eISSN">1536-5964</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Coronary Artery Bypass</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Negative-Pressure Wound Therapy (methods)</term><term>Pilot Projects</term><term>Postoperative Complications (prevention & control)</term><term>Saphenous Vein (transplantation)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Complications postopératoires ()</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pontage aortocoronarien</term><term>Projets pilotes</term><term>Sujet âgé</term><term>Traitement des plaies par pression négative ()</term><term>Veine saphène (transplantation)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Negative-Pressure Wound Therapy</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Saphenous Vein</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Coronary Artery Bypass</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Complications postopératoires</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pontage aortocoronarien</term><term>Projets pilotes</term><term>Sujet âgé</term><term>Traitement des plaies par pression négative</term><term>Veine saphène</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec sec-type="background"><title>Backgrounds:</title><p>The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial.</p></sec><sec sec-type="methods"><title>Methods:</title><p>A single-center, pilot randomized controlled trial was conducted. From December 2013 to March 2014, a total of 72 coronary heart disease patients (48 men and 24 women) received CABG therapy, with great saphenous veins were selected as grafts. Patients were equally randomized into a treatment and a control group. After the harvesting of the great saphenous veins and direct closure of the wound with sutures, b-NPWT was used for the thigh incision in the treatment group for 5 days (treatment thigh). Traditional surgical pads were applied to both the shank incisions of the treatment group patients (treatment shank) and the entire incisions of the control group (control thigh, control shank). Postoperative complications were recorded and statistically analyzed based on outcomes of thigh treatment, shank treatment, thigh control, and shank control groups.</p></sec><sec sec-type="results"><title>Results:</title><p>The incidence rates of early complications, such as lymphorrhagia, lymphoedema, infection, wound dehiscence, and skin flap necrosis, of the vascular donor site in the thigh treatment group was significantly lower than those in the 3 other groups.</p></sec><sec sec-type="conclusion"><title>Conclusions:</title><p>The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting.</p></sec><sec><title>Trial registration:</title><p>ClinicalTrials.gov. The unique registration number is NCT02010996.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kim, Kb" uniqKey="Kim K">KB Kim</name></author><author><name sortKey="Lim, C" uniqKey="Lim C">C Lim</name></author><author><name sortKey="Lee, C" uniqKey="Lee C">C Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kamiya, H" uniqKey="Kamiya H">H Kamiya</name></author><author><name sortKey="Watanabe, G" uniqKey="Watanabe G">G Watanabe</name></author><author><name sortKey="Takemura, H" uniqKey="Takemura H">H Takemura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Raja, Sg" uniqKey="Raja S">SG Raja</name></author><author><name sortKey="Dreyfus, Gd" uniqKey="Dreyfus G">GD Dreyfus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maniar, Hs" uniqKey="Maniar H">HS Maniar</name></author><author><name sortKey="Barner, Hb" 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Endara</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><noCountry><name sortKey="Song, Zhigang" sort="Song, Zhigang" uniqKey="Song Z" first="Zhigang" last="Song">Zhigang Song</name><name sortKey="Xu, Zhiyun" sort="Xu, Zhiyun" uniqKey="Xu Z" first="Zhiyun" last="Xu">Zhiyun Xu</name><name sortKey="Ye, Xiaofei" sort="Ye, Xiaofei" uniqKey="Ye X" first="Xiaofei" last="Ye">Xiaofei Ye</name><name sortKey="Yu, Yongchao" sort="Yu, Yongchao" uniqKey="Yu Y" first="Yongchao" last="Yu">Yongchao Yu</name></noCountry><country name="République populaire de Chine"><noRegion><name sortKey="Xue, Chunyu" sort="Xue, Chunyu" uniqKey="Xue C" first="Chunyu" last="Xue">Chunyu Xue</name></noRegion><name sortKey="Bi, Hongda" sort="Bi, Hongda" uniqKey="Bi H" first="Hongda" last="Bi">Hongda Bi</name><name sortKey="Li, Junhui" sort="Li, Junhui" uniqKey="Li J" first="Junhui" last="Li">Junhui Li</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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