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頁籤選單縮合
題名 | Surgical Site Infection Control Using Both Open and Suction Drains in Head and Neck Cancer Patients Receiving Soft Tissue Reconstruction=合併開放及密閉式引流對於頭頸癌軟組織重建之傷口感染控制 |
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作者 | 葉亘耕; 曹中侃; 張乃仁; 吳至偉; 黃嫆如; 高煌凱; 鄭明輝; 魏福全; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷期 | 24:1 2015.03[民104.03] |
頁次 | 頁1-9 |
分類號 | 416.21 |
關鍵詞 | 頭頸癌; 軟組織重建; 傷口感染; Head and neck cancer; Surgical site infection; Open drain; Close drain; Suction drain; |
語文 | 英文(English) |
中文摘要 | 背景:傷口感染是頭頸癌病患術後重建後常見的併發症。已有很多研究討論關於術後感染的危險因子,但是關於術後傷口的引流管放置對於傷口感染的影響的相關研究仍然尚未有個定論。目的及目標:過去頭頸癌病患重建術後,密閉式抽吸引流管的放置往往可以協助傷口積液的引流及促進傷口癒合。本篇研究的目標是除了密閉式抽吸引流管之外,再加上開放式的引流管協助傷口積液引流,藉以協助傷口感染的控制。材料及方法:採回溯性研究2011年至2012年於林口長庚紀念醫院接受頭頸癌術後軟組織重建病患。將病患依照術後傷口引流管放置方式,分為合併開放及密閉式引流管族群和密閉式引流管置放族群兩組病患,研究探討病患術後傷口感染的徵象發生率之差異。結果:共469例病患納入本次研究中,其中292例病患接受合併開放及密閉式引流管放置,171例病患僅接受密閉式引流管放置。接受合併開放及密閉式引流管的族群術後有顯著較低的發燒機率(減少8%發生機率)。關於其餘局部傷口感染徵象,接受合併開放及密閉式引流管的族群亦有較低的發生比率。結論:對於頭頸癌接受重建的病患,合併開放及密閉式引流管的置放能夠降低術後發燒的發生比率。 |
英文摘要 | Background: Surgical site infections (SSI) are one of the major complications and key prognosis factor in postoncologic head and neck cancer patients undergoing immediate reconstruction with free tissue transfer. Several studies have identified the risk factors for SSI, but little is known about how the use of drains affects postoperative infection signs and control. This study investigates the benefit of placing an additional open drain in the submandibular triangle, near the flap pedicle and away from the suction drain, to augment drainage. Methods: A two-year retrospective chart review of head and neck cancer patients who received immediate free flap reconstruction after tumour resection was performed. The experimental group consisted of patients with a closed suction drain and an additional open drain (AOD). The control group consisted of patients with only a close suction drain (CSD). Results: 469 patients met the inclusion criteria. The experimental group consisted of 292 patients and the control group of 177. Presence of postoperative fever was statistically significantly reduced in 8% of the experimental group (p=0.03). Clinical signs of infection were reduced in the experimental group, but were not statistically significant. Conclusion: A combined use of a closed suction drain in the posterior triangle of neck and an additional open drain in the submandibular triangle to augment drainage function in postoncologic head and neck cancer patients reconstructed with free tissue transfer is safe and decreases the postoperative incidence of fever by 8%. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。