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[感染性腹壁与腹壁破裂]

[Infected abdominal wall and burst abdomen].

作者信息

Fleischer G M, Rennert A, Rühmer M

机构信息

Chirurgische Klinik der Vogtlandklinikum Plauen GmbH, Plauen.

出版信息

Chirurg. 2000 Jul;71(7):754-62. doi: 10.1007/s001040051134.

Abstract

Deep wound infection of the abdominal wall and postoperative abdominal wound rupture are dangerous complications of laparotomy that require emergency operative intervention. The wound infection quota after laparotomy is between 5 and 10%. While subcutaneous infections heal without consequences after wound treatment, deep infections of incisional wounds are a problem. The cause is often an intra-abdominal infection. There are some standard operational measures: consistent debridement of the necrotic parts, careful re-exploration of the intra-abdominal site and early fascial closure with special sutures. All other procedures depend on the individual case. Abdominal wall rupture only occurs in 1% of the cases, but the mortality is high (15-45%). Besides local wound factors and the technical aspects, there a many general causes. Abdominal wall rupture also requires emergency operation. Repeated wound closure without further steps is possible in half of the cases. The mass technique should be used. Both deep wound infections and rupture are important complications in the development of incisional hernias.

摘要

腹壁深部伤口感染和术后腹部伤口破裂是剖腹手术的危险并发症,需要紧急手术干预。剖腹手术后的伤口感染率在5%至10%之间。虽然皮下感染经伤口处理后可无后遗症地愈合,但切口深部感染却是个问题。其原因通常是腹腔内感染。有一些标准的手术措施:对坏死部位进行持续清创、仔细再次探查腹腔部位以及用特殊缝线早期缝合筋膜。所有其他程序则取决于具体病例。腹壁破裂仅发生在1%的病例中,但死亡率很高(15% - 45%)。除了局部伤口因素和技术方面外,还有许多一般原因。腹壁破裂也需要紧急手术。半数病例可以在不采取进一步措施的情况下反复缝合伤口。应采用块状技术。深部伤口感染和破裂都是切口疝形成过程中的重要并发症。

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