RESUMO
BACKGROUND: While negative pressure wound therapy (NPWT) has been used for decades, there is a paucity of data regarding the appropriate length of time between dressing changes. METHODS: This was a prospective, randomized control trial examining time to wound closure in open midline laparotomy wounds treated with NPWT. The control group received the standard thrice weekly sponge changes (thrice) and the treatment group received once weekly sponge changes (once). RESULTS: 44 patients met study criteria over a 3-year period. There was no difference in NPWT duration between the two groups (37.1 vs 34.7 days, pâ¯=â¯0.7324), even after adjusting for potential confounders (pâ¯=â¯0.8091). No differences were found in initial wound size or reduction. The wound complication profile was similar for both groups. CONCLUSION: There is no difference in time to wound closure or complications with NPWT dressing changes once a week compared to the standard three times a week.
Assuntos
Bandagens , Laparotomia , Tratamento de Ferimentos com Pressão Negativa/métodos , Cicatrização , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Fatores de Tempo , Adulto JovemAssuntos
Traumatismos Abdominais/complicações , Aorta Abdominal/lesões , Artéria Ilíaca/lesões , Traumatismo Múltiplo , Lesões do Sistema Vascular/etiologia , Ferimentos não Penetrantes/complicações , Traumatismos Abdominais/classificação , Traumatismos Abdominais/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Índices de Gravidade do Trauma , Estados Unidos/epidemiologia , Lesões do Sistema Vascular/classificação , Lesões do Sistema Vascular/epidemiologia , Ferimentos não Penetrantes/classificação , Ferimentos não Penetrantes/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: To our knowledge, the prevalence of Systemic Inflammatory Response Syndrome (SIRS) in pediatric patients with appendicitis has not been previously investigated. Our specific aim was to determine the prevalence of SIRS at the time of presentation of pediatric patients with appendicitis. Additionally, we sought to determine if the presence of SIRS had any value in predicting their clinical outcomes. METHODS: This retrospective cohort study included pediatric patients (age <17 years) presenting to a single hospital and being diagnosed with appendicitis between July 1, 2011, and June 30, 2012. The primary exposure variable of interest was SIRS, dichotomously defined as positive or negative. The primary outcome of interest was the presence/development of an intraabdominal abscess. The secondary outcome of interest was length of hospital stay (LOS). Chi-squared and t-tests were used to evaluate the association between presence of SIRS and development of abscess and LOS. RESULTS: This study consisted of 212 patients. The definition of SIRS was met in 66 patients (31.1%). Thirty of the 66 (45.6%) patients with SIRS had/developed an abscess versus 28 (19.2%) of those without SIRS (P<0.001). Patients with SIRS had a mean LOS of 4 days (+/-2.7), while those without SIRS stayed a mean of 2.5 days (+/-2.3) [p<0.0001]). Adjusting for age did not alter these associations. CONCLUSION: Our study found a 31.1% prevalence of SIRS in pediatric patients presenting with appendicitis. Our results suggest these patients with SIRS have a significantly higher risk of having/developing an intraabdominal abscess (RR, 2.4; 95% CI: 1.6-3.6) and significantly longer LOS.
