Background. Topical negative pressure therapy (NPWT) is an advanced wound treatment method designed to provide continuously or intermittently subatmospheric pressure through a dressing whose properties increase local blood flow, decrease local edema, increase granulation tissue development, provide a moist wound environment, and accelerate epithelialization. Aim. The purpose of this thesis is to analyze the use of negative topical pressure dressing (NPWT) and how clinically effective and safe this treatment method is for the treatment of surgical wounds of different etiology compared with conventional treatment, by investigating the nursing contribution so that adequate care is provided throughout the patient's caregiving period. Materials and Methods. For the purpose of the study, a literature review was conducted within international databases such as Pubmed, Cinhal, Cochrane Library, Scopus, Trip, and Google Scholar. A total of 27 studies (7 meta-analyses, 13 RCTs, 7 observational studies) were identified. Results. The selected studies were divided into four macrocategories based on the site of surgery and the population analyzed (abdominal, orthopedic, thoracic, pathology patients). Treatment by NPWT has been shown to be useful in preventing surgical site infections (abdominal, thoracic surgery and in patients with oncologic pathology) and in reducing the incidence of other postoperative complications (dehiscence, seroma and hematoma) in patients undergoing abdominal, orthopedic and oncologic surgery. The treatment also showed a cost reduction in accelerating the wound healing process and reducing some complications. Conclusions. NPWT treatment is safe and effective in many aspects and improves the healing process of surgical wounds by providing more beneficial results that are not otherwise achievable by treatment with conventional dressings. Moreover, due to its different mechanisms of action, it can be used in hospitalized patients, but also in emergency and home settings. Keywords: negative pressure wound therapy (NPWT), vacuum assisted therapy, negative pressure wound therapy with instillation (NPWTi), surgical wound, surgical site infection (SSI), standard surgical dressings.
Background. La terapia topica a pressione negativa (NPWT) è un metodo avanzato di trattamento delle ferite progettato per fornire in modo continuo o intermittente una pressione subatmosferica attraverso una medicazione le cui proprietà aumentano il flusso sanguigno locale, diminuisce l'edema locale, aumenta lo sviluppo del tessuto di granulazione, fornisce un ambiente umido alla ferita, accelera l’epitelizzazione. Obiettivo. Lo scopo della tesi è analizzare l’utilizzo della medicazione a pressione topica negativa (NPWT) e quanto questo metodo di trattamento è efficace clinicamente e sicuro per il trattamento delle lesioni chirurgiche di diversa eziologia rispetto al trattamento convenzionale, approfondendo il contributo infermieristico affinché venga fornita un’assistenza adeguata nell’intero periodo di presa in carico del paziente. Materiali e metodi. Ai fini dello studio è stata svolta una revisione della letteratura all’interno di banche dati internazionali come Pubmed, Cinhal, Cochrane Library, Scopus, Trip e Google Scholar. Sono stati identificati un totale di 27 studi (7 meta- analisi, 13 RCT, 7 studi osservazionali). Risultati. Gli studi selezionati sono stati suddivisi in quattro macrocategorie in base alla sede dell’intervento chirurgico e alla popolazione analizzata (addominale, ortopedico, toracico, pazienti con patologia). Il trattamento mediante NPWT si è dimostrato utile nella prevenzione delle infezioni del sito chirurgico (chirurgia addominale, toracica e in pazienti con patologia oncologica) e nel ridurre l’incidenza di altre complicanze post-operatorie (deiscenze, sieroma ed ematoma) in pazienti sottoposti a intervento addominale, ortopedico e con patologia oncologica. Il trattamento ha evidenziato inoltre una riduzione a livello di costi per l'accelerazione del processo di guarigione delle ferite e la riduzione di alcune complicanze. Conclusioni. Il trattamento con la NPWT è sicuro ed efficace in molti aspetti e migliora il processo di guarigione delle ferite chirurgiche garantendo risultati più vantaggiosi che non sono altrimenti raggiungibili dal trattamento con le medicazioni convenzionali. Inoltre, grazie ai suoi diversi meccanismi d’azione può essere utilizzata in regime di ricovero, in emergenza e domiciliare. Keywords: negative pressure wound therapy (NPWT), vacuum assisted therapy, negative pressure wound therapy with instillation (NPWTi), surgical wound, surgical site infection (SSI), standard surgical dressings.
Trattamento delle ferite chirurgiche: confronto tra la terapia a pressione topica negativa e medicazioni standard. Una revisione della letteratura.
NEDZIP, SALKA
2021/2022
Abstract
Background. Topical negative pressure therapy (NPWT) is an advanced wound treatment method designed to provide continuously or intermittently subatmospheric pressure through a dressing whose properties increase local blood flow, decrease local edema, increase granulation tissue development, provide a moist wound environment, and accelerate epithelialization. Aim. The purpose of this thesis is to analyze the use of negative topical pressure dressing (NPWT) and how clinically effective and safe this treatment method is for the treatment of surgical wounds of different etiology compared with conventional treatment, by investigating the nursing contribution so that adequate care is provided throughout the patient's caregiving period. Materials and Methods. For the purpose of the study, a literature review was conducted within international databases such as Pubmed, Cinhal, Cochrane Library, Scopus, Trip, and Google Scholar. A total of 27 studies (7 meta-analyses, 13 RCTs, 7 observational studies) were identified. Results. The selected studies were divided into four macrocategories based on the site of surgery and the population analyzed (abdominal, orthopedic, thoracic, pathology patients). Treatment by NPWT has been shown to be useful in preventing surgical site infections (abdominal, thoracic surgery and in patients with oncologic pathology) and in reducing the incidence of other postoperative complications (dehiscence, seroma and hematoma) in patients undergoing abdominal, orthopedic and oncologic surgery. The treatment also showed a cost reduction in accelerating the wound healing process and reducing some complications. Conclusions. NPWT treatment is safe and effective in many aspects and improves the healing process of surgical wounds by providing more beneficial results that are not otherwise achievable by treatment with conventional dressings. Moreover, due to its different mechanisms of action, it can be used in hospitalized patients, but also in emergency and home settings. Keywords: negative pressure wound therapy (NPWT), vacuum assisted therapy, negative pressure wound therapy with instillation (NPWTi), surgical wound, surgical site infection (SSI), standard surgical dressings.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/45365