Clinical Application of Vacuum Sealing Drainage for the Treatment of Deep Burn Wounds

Efficacy of prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review meta-analysis

INTRODUCTION

The susceptibility to surgical site occurrence (SSO) is high following ventral hernia repair (VHR) surgery. SSO severely increases the physical and mental burden on patients. The main purpose of this review was to analyze the efficacy of negative pressure wound therapy (NPWT) after open VHR(OVHR) and explore benefits to patients.

METHODS

The Cochrane Library, PubMed, and Embase databases were searched from the date of establishment to 15 October 2022. All randomized controlled trials and retrospective cohort studies comparing NPWT with standard dressings after OVHR were included. The Revman 5.4 software recommended by Cochrane and the STATA16 software were used in this meta-analysis.

RESULTS

Fifteen studies (involving 1666 patients) were identified and included in the meta-analysis, with 821 patients receiving NPWT. Overall, the incidence rate of SSO in the NPWT group was lower compared to the control group (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.21-0.93; I2 = 86%; P = 0.03). The occurrence rate of surgical site infection (SSI; OR = 0.51; 95% CI = 0.38-0.68, P < 0.001), wound dehiscence (OR = 0.64; 95% CI = 0. 43-0.96; P = 0.03), and hernia recurrence (OR = 0.51; 95% CI = 0.28-0.91, P = 0.02) was also lowered. There was no significant difference in seroma (OR = 0.76; 95% CI = 0.54-1.06; P = 0.11), hematoma (OR = 0.53; 95% CI = 0.25-1.11; P = 0.09), or skin necrosis (OR = 0.83; 95% CI = 0.47-1.46; P = 0.52).

CONCLUSION

NPWT can effectively decrease the occurrence of SSO, SSI wound dehiscence and hernia recurrence and should be considered following OVHR.

An Overview of Recent Developments in the Management of Burn Injuries

According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.

Roles of negative pressure wound therapy for scar revision

The purpose of this study is to review the research progress of negative pressure wound therapy (NPWT) for scar revision and discuss the prospects of its further study and application. The domestic and foreign literatures on NPWT for scar revision were reviewed. The mechanism and application were summarized. NPWT improves microcirculation and lymphatic flow and stimulates the growth of granulation tissues in addition to draining secretions and necrotic tissue. As a significant clinical therapy in scar revision, NPWT reduces tension, fixes graft, and improves wound bed. In the field of scar revision, NPWT has been increasingly used as an innovative and constantly improving technology.

In-hospital nursing care intervention increasing the effect of vacuum sealing drainage on wound healing: A meta-analysis

Vacuum sealing drainage (VSD) could effectively drain superficial wounds and deep tissues, which is beneficial for wound healing. More incentives in nursing care to improve the therapeutic effect of VSD on wound healing were further investigated. Different databases were retrieved for full-text publications about the comparison between intervention nursing care and regular nursing care. Heterogeneity was detected by I2 method, and a random-effect model was applied for data pooling if there existed heterogeneity. Publication bias was analysed by a funnel plot. Eight studies with 762 patients were included for final meta-analysis. In the nursing care intervention group, shorter hospital stay duration (pooled SMD = -2.602, 95% confidence interval: -4.052--1.151), shorter wound healing time (pooled SMD = -1.105, 95% confidence interval: -1.857--0.353), lower pain score (pooled SMD = -2.490, 95% confidence interval: -3.521--1.458), lower drainage tube blocked rate (pooled RR = 0.361, 95% confidence interval: 0.268-0.486), and higher nursing satisfaction (pooled RR = 1.164, 95% confidence interval: 1.095-1.237) was confirmed. More active and incentive nursing care could significantly improve the therapeutic effect of VSD on wound healing, in terms of hospitalisation time, wound healing time, painful symptoms, drainage tube blockage, and nursing satisfaction.