ObjectiveTo investigate the effcacy of subcutaneous placement of negative pressure drainage tube in the prevention of incision fat liquefaction in obese patients after abdominal surgery. MethodsThe wound healing situation in 84 obese patients who underwent abdominal surgery in our department from January 2013 to May 2015 were retrospectively analyzed. The patients were divided into tube placement group (n=39) and control group (n=45). Patients in the tube placement group accepted negative pressure drainage tube placement, while those in the control group underwent routine suturing of the incision without negative pressure drainage tube. The incision healing grade and fat liquefaction rate of the two groups of patients were compared and analyzed. ResultsThere was no significant diTherence in grade-A and –B healing rate and fat liquefaction rate between the two groups (P>0.05), but grade-C healing rate and the second-stage suturing rate in the tube placement group were significantly lower than those of the control group (P<0.05). There was no significant diTherence in grade-C healing rate between the two groups for type-Ⅱ incisions (P>0.05), while the grade-C healing rat of patients with type-Ⅲ incisions was significantly lower in the tube placement group than that in the control group (P<0.05). ConclusionNegative pressure drainage tube can decrease grade-C healing rate and second-stage suturing rate as well as grade-C healing rate of type-Ⅲ incisions in obese patients after abdominal surgery.
ObjectiveTo summarize surgical experience and explore the best treatment strategy for the management of complicated mediastinitis after cardiac surgery. MethodsClinical data of 18 patients who received vascularized muscle flap transposition combined with negative pressure wound therapy (NPWT)for the treatment of complicated mediastinitis after cardiac surgery in one stage in the Department of Cardiac Surgery of Beijing Anzhen Hospital, Capital Medical University between June 2006 and December 2012 were retrospective analyzed. There were 12 male and 6 female patients with their average age of 65.5±8.2 years. The average interval between cardiac surgery and vascularized muscle flap reconstruction was 12.5±5.8 days. ResultsPostoperatively, 1 patient died of recurrent mediastinitis, sepsis and multiple organ dysfunction syndrome. Seventeen patients had an uneventful postoperative recovery and one-stage wound healing. Postoperative hospital stay was 18.6±7.2 days and wound healing time was 4.5±2.4 weeks. All the 17 patients were followed up for over 6 months, no recurrent mediastinitis was observed, and they had a good quality of life. ConclusionVascularized muscle flap transposition combined with NPWT is a simple and effective surgical strategy for the treatment of complicated mediastinitis after cardiac surgery in one-stage.
In order to solve the problems of difficult test, high cost and long cycle in the development of large-scale airborne negative pressure isolation system, the simulation analysis of negative pressure response characteristics is carried out around various aviation conditions such as aircraft ascending, leveling and descending, especially rapid decompression, based on the computational fluid dynamics (CFD) method. The results showed that the isolation cabin could achieve –50 Pa pressure difference environment and form a certain pressure gradient. The exhaust air volume reached the maximum value in the early stage of the aircraft’s ascent, and gradually decreased with the increase of altitude until it was level flying. In the process of aircraft descent, the exhaust fan could theoretically maintain a pressure difference far below –50 Pa without working; Under the special condition of rapid pressure loss, it was difficult to deal with the rapid change of low pressure only by the exhaust fan, so it was necessary to design safety valve and other anti-leakage measures in the isolation cabin structure. Therefore, the initial stage of aircraft ascent is the key stage for the adjustment and control of the negative pressure isolation system. By controlling the exhaust air volume and adjusting parameters, it can adapt to the change of low pressure under normal flight conditions, form a relatively stable negative pressure environment, and meet the needs of biological control, isolation and transport.