Ventajas y complicaciones de la terapia de presión negativa versus terapia convencional en el tratamiento de heridas complejas, Hospital José Carrasco Arteaga, 2018

Abstract

Background: Negative pressure therapy as an advanced method, based on the use of subatmospheric pressure, against complex wounds that are difficult to treat. Objective: To determine the advantages and complications of negative pressure therapy (NPT) and conventional therapy (CT) in the treatment of complex wounds, in the José Carrasco Arteaga Hospital. Materials and Methods: An observational, analytical, transversal study was conducted; which included 138 clinical records of patients with complex wounds: 69 received NPT and 69 CT admitted to the José Carrasco Hospital, from march to december 2018. For the Descriptive statistical analysis frequencies and percentages were used; to establish the association of advantages and complications between therapies, a bivariate analysis was performed using Ods Ratio with 95% Confidence Interval and multivariate logistic regression. Results: The bivariate analysis of the advantages showed that the TPN decreases healing time (OR = 0.2055; 95% CI: 0.071-0.588, p value = 0.001) and total treatment (OR = 0.2766; 95% CI: 0.108-0.707, p value = 0.005); reduce the number of cures (OR = 0.1083; 95% CI: 0.035-0.332, p value = <0.001) and surgeries (OR = 0.0775; 95% CI: 0.009-0.618, p value = 0.002). Regarding complications, the risk of infection (OR = 0.0712; 95% CI: 0.023-0.217, p-value = <0.001), severe pain (OR = 0.1154; 95% CI: 0.037-0.355, p-value = <0.001) and recurrence (OR = 0.0417; 95% CI: 0.014-0.117, p value = <0.001). The multivariate analysis showed statistical association with evolutionary clinical variables but not with sociodemographic ones. Conclusions: The use of NPT compared to CT reduces the risk of infection, recurrence, pain level, shortens hospital stay times and reduces the number of cures and surgical interventions.