Yeh C H, Lin P J, Chu J J
Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C.
Chang Gung Med J. 2001 Jul;24(7):451-4.
How to optimally treat deep sternal wound infection after open wound infection remains controversial. Biomaterial advances have made local antibiotics-releasing systems a promising alternative for treating deep sternal wound infection. Two patients with deep sternal wound complications were treated with radical wound debridement, sternal refixation, retrosternal suction drainage, bilateral pectoralis major muscle flaps and placement of collagenous drug carriers loaded with vancomycin underneath, above and between the sternal edges. No treatment failure and death occurred in these patients. There were no side effects, treatment failures or deaths after adjuvant treatment with collagenous vancomycin. Preliminary results of these 2 case studies demonstrate the feasibility of successfully treating deep sternal wound infections with collagenous vancomycin in combination with surgical debridement. This technique is easily performed, reliable and safe.
开放性伤口感染后如何最佳地治疗深部胸骨伤口感染仍存在争议。生物材料的进步使局部抗生素释放系统成为治疗深部胸骨伤口感染的一种有前景的替代方法。两名深部胸骨伤口并发症患者接受了彻底的伤口清创、胸骨重新固定、胸骨后负压引流、双侧胸大肌皮瓣以及在胸骨边缘下方、上方和之间放置负载万古霉素的胶原药物载体治疗。这些患者未发生治疗失败和死亡情况。使用胶原万古霉素辅助治疗后未出现副作用、治疗失败或死亡。这两个病例研究的初步结果表明,胶原万古霉素联合手术清创成功治疗深部胸骨伤口感染是可行的。该技术操作简便、可靠且安全。