Herrera Mauricio F, Bauer Greg, Reynolds Fletcher, Wilk Richard M, Bigliani Louis U, Levine William N
New York Orthopaedic Hospital, New York Presbyterian Medical Center, New York, NY 10032, USA.
J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):605-8. doi: 10.1067/mse.2002.127302.
A consecutive case series from 2 institutions of patients with postoperative wound infections after mini-open rotator cuff repair was reviewed. Between 1991 and 2000, 360 patients underwent mini-open rotator cuff repair after arthroscopic subacromial decompression. Seven patients had postoperative infection develop (1.9%). All patients were men, with a mean age of 55 years (range, 40-64 years). Treatment included serial irrigation and debridement, long-term intravenous antibiotics, and revision rotator cuff repair. Mean follow-up after definitive treatment was 32 months (range, 12-57 months). Propionibacter acnes was present in 6 of 7 patients (86%) with infections. The initial rotator cuff repair was disrupted in 4 shoulders and intact in 3. A revision rotator cuff repair was performed at the final irrigation and debridement in all 4 shoulders. Results were 100% satisfactory. The mean American Shoulder and Elbow Surgeons pain score improved from 7 (range, 6-9) preoperatively to 1 (range, 0-2). The mean final score was 95. Because these infections were noted to occur only in arthroscopically assisted rotator cuff repairs, a second preparation and draping were introduced as routine protocol. No postoperative infections have occurred in the ensuing 200 mini-open rotator cuff repairs.
回顾了来自2家机构的一系列连续性病例，这些病例均为小切口肩袖修复术后发生伤口感染的患者。1991年至2000年期间，360例患者在关节镜下肩峰下减压术后接受了小切口肩袖修复。7例患者发生了术后感染（1.9%）。所有患者均为男性，平均年龄55岁（范围40 - 64岁）。治疗包括反复冲洗和清创、长期静脉使用抗生素以及肩袖修复翻修术。确定性治疗后的平均随访时间为32个月（范围12 - 57个月）。7例感染患者中有6例（86%）存在痤疮丙酸杆菌。4例肩关节的初始肩袖修复被破坏，3例完整。所有4例肩关节在最后一次冲洗和清创时均进行了肩袖修复翻修术。结果令人满意，满意度达100%。美国肩肘外科医师协会的平均疼痛评分从术前的7分（范围6 - 9分）改善至1分（范围0 - 2分）。平均最终评分为95分。由于这些感染仅在关节镜辅助肩袖修复术中被发现，因此引入了第二次铺巾准备作为常规操作流程。在随后的200例小切口肩袖修复术中未发生术后感染。
