Topical negative pressure (TNP) for partial thickness burns

  • Review
  • Intervention

Authors

  • Jason Wasiak,

    Corresponding author
    1. Monash University, Alfred Hospital, Victorian Adult Burns Service and School of Public Health and Preventative Medicine, Melbourne, Victoria, Australia
    • Jason Wasiak, Victorian Adult Burns Service and School of Public Health and Preventative Medicine, Monash University, Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria, 3181, Australia. J.Wasiak@alfred.org.au. jwasiak1971@gmail.com.

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  • Heather Cleland

    1. The Alfred Hospital, Victorian Adult Burns Service, Melbourne, Victoria, Australia
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Abstract

Background

A burn wound is a complex and evolving injury, with both local and systemic consequences. Treatments include using a variety of dressings, but newer strategies such as topical negative pressure therapy (TNP) have been developed to try and promote the wound healing process and minimise burn wound progression. TNP uses a suction force to drain excess fluids.

Objectives

To assess the effectiveness of TNP for those people with partial thickness burns.

Search methods

For this update we searched the Cochrane Wounds Group Specialised Register (searched 1 September 2010), the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2010 Issue 3), Ovid MEDLINE (1950 to August Week 3 2010), Ovid EMBASE (1980 to 2010 Week 34) and EBSCO CINAHL (1982 to 27 August 2010).

Selection criteria

All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of TNP for partial thickness burns.

Data collection and analysis

Two authors using standardised forms extracted the data independently. We assessed each trial for internal validity, and resolved differences by discussion.

Main results

One RCT, which was an interim report, satisfied the inclusion criteria. We undertook a narrative synthesis of results, as the absence of data, poor reporting or both precluded us from carrying out any formal statistical analysis. The trial was at high risk of bias.

Authors' conclusions

There is a no evidence regarding the use of TNP for treating partial thickness burn wounds.

摘要

背景

局部負壓 (Topical negative pressure; TNP) 用於治療局部深層燒傷 (partial thickness burns)

燒傷的傷口是一種複雜且逐步演變的外傷,可能造成局部或系統性的後果,其治療包括使用各種敷料,不過有些更先進的方法如局部負壓療法已經被用於促進傷口的癒合,以及避免燒傷傷口在急性期惡化而影響到更深層的組織。局部負壓是以吸力來吸除過量的液體。

目標

評估TNP用於局部深層燒傷患者的效果。

搜尋策略

我們搜尋了Cochrane Wounds Group Specialised Register (搜尋時間為2007年4月), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 第2期,2007年), Ovid MEDLINE (1950 年到2007年4月第4周), Ovid EMBASE (1980年到2007年第18周) 以及Ovid CINAHL (1982年到2007年4月第4周).

選擇標準

所有評估TNP用於局部深層燒傷的安全性與效果之隨機對照試驗 (randomised controlled trials;RCTs) 和具有控制組的臨床試驗 (controlled clinical trials;CCTs) 。

資料收集與分析

由兩位作者獨立以標準化的格式摘錄資訊,每個試驗都評估其內在效度,遇有有分歧時則透過討論來解決。由於資料有所遺漏、報告不完整,這兩者使得作者無法進行任何正規的統計分析,因此最後採取綜合敘述的方式來報告結果。

主要結論

有1個RCT符合我們的選擇標準,而這個試驗在方法學上的品質不佳。

作者結論

有1個品質欠佳的RCT研究過TNP用於局部深層燒傷,其樣本數與檢力不足以判斷出TNP和傳統燒傷傷口敷料治療間是否有差異。

翻譯人

本摘要由成功大學附設醫院邱曉萱翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

缺乏實證說明局部負壓療法對於治療局部深層燒傷的患者是否有效。局部負壓 (TNP) 療法是指在傷口上施加負壓,在這種情況下,壓力可用於幫助抽吸過量液體、降低感染率以及增加傷口部位的血流,接著提供傷口氧氣與營養,以加速傷口的痊癒。TNP的別名是真空抽吸器 (vacuumassisted closure;VAC) ,用於緊緊密合吸附在傷口表面。

Plain language summary

Topical negative pressure (TNP) for treating partial thickness burns

Topical negative pressure (TNP) therapy is the application of negative pressure across a wound to help the wound to heal. In this instance, the pressure is used to help the drainage of excess fluid, reduce infection rates and increase localised blood flow, thereby supplying the burn wound with oxygen and nutrition to promote the healing process. Alternative names for TNP include vacuum-assisted closure (VAC) and sealed surface wound suction. There is a lack of evidence about whether TNP therapy is effective in treating people with partial thickness burns.

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