二氧化碳激光灭菌在感染性正中开胸伤口手术治疗中的应用
CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds.
作者信息
Lee J S, Tarpley S K, Miller A S
机构信息
Department of Surgery, University of Oklahoma School of Medicine-Tulsa, USA.
出版信息
South Med J. 1999 Apr;92(4):380-4. doi: 10.1097/00007611-199904000-00005.
BACKGROUND
We examined the use of CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds. Deep wound infection after median sternotomy is infrequent (1% to 5% of all cases) but is associated with significant morbidity, mortality, and cost.
METHOD
Twenty-four consecutive patients with median sternotomy wound infection were treated by one plastic surgeon using a CO2 laser to sterilize wounds after debridement and before flap closure. The rectus abdominis muscle flap was primarily used, but the choice of muscle flap was case dependent.
RESULTS
To date, no patient in this series has had postoperative wound infection, breakdown, or flap loss. One patient did have superficial skin loss.
CONCLUSION
Although the morbidity rate was 17%, all patients had intact wounds. None of the 5 deaths was related to wound infection. We found that CO2 laser sterilization in the surgical treatment of sternal wound infections decreased morbidity, mortality, and cost.
背景
我们研究了二氧化碳激光消毒在感染性正中胸骨切开术伤口手术治疗中的应用。正中胸骨切开术后深部伤口感染并不常见（占所有病例的1%至5%），但与显著的发病率、死亡率和成本相关。
方法
24例连续的正中胸骨切开术伤口感染患者由一名整形外科医生治疗，在清创后和皮瓣闭合前使用二氧化碳激光对伤口进行消毒。主要使用腹直肌肌皮瓣，但肌皮瓣的选择取决于具体病例。
结果
迄今为止，该系列中没有患者出现术后伤口感染、裂开或皮瓣丢失。有1例患者出现了浅表皮肤缺损。
结论
尽管发病率为17%，但所有患者的伤口均保持完整。5例死亡病例均与伤口感染无关。我们发现，二氧化碳激光消毒在胸骨伤口感染的手术治疗中降低了发病率、死亡率和成本。
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