Összefoglaló. A negatív nyomású sebkezelés mai formájában történő, a mindennapos sebészi gyakorlatba történő bevezetése az 1990-es években történt meg. A kezelés célja a váladék elszívása mellett a mikrocirkuláció javítása és a seb granulációs folyamatainak serkentése. A modern sebkezelési szemlélettel a fenti módszert alkalmazhatjuk akut és krónikus sebgyógyulási zavarok esetében egyaránt, használatához azonban fontos a megfelelően szakképzett személyzet és a jól kiválasztott beteg egyaránt. Összefoglalásunkban arra vállalkoztunk, hogy ismertetjük a negatív nyomású rendszer alkotórészeit, a sebkezelés ilyen formában történő működését, bemutatjuk az eszközök különféle típusait, és meghatározzuk azon betegek körét, akik esetében a kezelés sikerrel alkalmazható. Kitérünk a sebkezelő rendszerek különféle technikai módozataira, bemutatjuk a kezelés pontos gyakorlatát, az indikációs lehetőségeket és a kontraindikáció helyzeteit, választ adunk a kezelés során felmerülő fontos kérdésekre, felhívjuk a figyelmet az esetlegesen fellépő szövődmények lehetőségeire, és közzétesszük azok elhárítási módjait. A negatív nyomású sebkezelésnek léteznek különleges formái (incizionális, endoluminalis és testüregen belül alkalmazott negatív nyomású sebkezelés), melyeket szintén részletesen bemutatunk, továbbá kitérünk az ambuláns betegkörben történő felhasználás részleteire. Cikkünk utolsó részében végül felhívjuk a figyelmet a negatív nyomású sebkezelés során jelentkező speciális helyzetekre (antikoaguláns terápia módosítása, multirezisztens kórokozók és vizsgálatok elvégzése a negatív nyomású sebkezelés alatt). Orv Hetil. 2022; 163(7): 271–278.
Summary. The introduction of negative pressure wound treatment in its current form into the daily surgical practice started in the 1990s. In addition to the suction of secretions, the aim of the treatment is to improve microcirculation and stimulate the granulation processes in the wound bed. Considering the modern wound management approach, the above method can be used to facilitate the wound healing process of both acute and chronic wounds. In the application of this method, it is important to emphasize the role of both the properly trained staff and the good patient selection. In our summary, we describe the components of the negative pressure system, the operation of wound care in this form, to present the different types of devices, and to identify the range of patients for whom the treatment can be used successfully. We cover the various technical methods of wound care systems, present the exact practice of treatment, the indications and contraindications, answer important questions that arise during treatment, draw attention to possible complications and discuss how to eliminate them. There are special forms of negative pressure wound care (incisional, endoluminal, and intracavitary negative pressure wound care), which are also presented in detail, as well as application of this treatment in outpatient care. Finally, we draw attention to some special issues that may arise during negative pressure wound treatment, e.g., modification of anticoagulant therapy and treatment of wounds contaminated by multidrug-resistant pathogens. Orv Hetil. 2022; 163(7): 271–278.
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