TRAUMA
Negative pressure wound therapy versus conventional wound dressings in treatment of open fractures: A systematic review and meta-analysis
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これにより、臨床的に意義のある研究をより早く認識することが可能になり、読者は将来の診療を形成する可能性が最も高い論文に集中することができます。
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2019;7(3):70 Int J Surg. 2018 May;53:72-79Eight randomized controlled trials were included in this meta-analysis which comparing negative pressure wound therapy and conventional dressings in wound management following open fracture. Pooled analysis demonstrated a significantly lower rate of infection among groups treated with negative pressure wound therapy compared to groups treated with conventional dressings.
Were the search methods used to find evidence (original research) on the primary question or questions stated?
Was the search for evidence reasonably comprehensive?
Were the criteria used for deciding which studies to include in the overview reported?
Was the bias in the selection of studies avoided?
Were the criteria used for assessing the validity of the included studies reported?
Was the validity of all of the studies referred to in the text assessed with use of appropriate criteria (either in selecting the studies for inclusion or in analyzing the studies that were cited)?
Were the methods used to combine the findings of the relevant studies (to reach a conclusion) reported?
Were the findings of the relevant studies combined appropriately relative to the primary question that the overview addresses?
Were the conclusions made by the author or authors supported by the data and or analysis reported in the overview?
How would you rate the scientific quality of this evidence?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
4/4
Introduction
4/4
Accessing Data
4/4
Analysing Data
4/4
Results
3/4
Discussion
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Infection following open wound fracture is a common complication which can negatively impact patient outcomes. Negative pressure wound therapy has been suggested as a method to improve outcomes compared to traditional dressings, and while a number of trials have been conducted, controversy still exists.
主な研究課題は何ですか？
In wound management after open fracture, is there any significant difference in outcome between negative pressure wound therapy and conventional dressings?
重要な知見は？
- The infection rate was significantly lower among NPWT groups compared to conventional dressing groups (8 studies; OR 0.17 [95%CI 0.09-0.32]).
- The requirement of flap surgery did not significantly differ between NPWT groups and conventional dressing groups (3 studies; OR 0.64 [95%CI 0.21-2.02]).
最も覚えておくべきことは？
In wound management of open fractures, negative pressure wound therapy was associated with a significantly lower rate of postoperative infection when compared to management with conventional dressings.
それが私の患者ケアにどのように影響するか？
The results of this study suggest that negative pressure wound therapy can reduce the rate of infection in the management of open fractures compared to conventional dressings. However, it should be determined if this reduction in infections is clinically significant and cost-effective.
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