Heitmann Christoph, Patzakis Michael J, Tetsworth Kevin D, Levin L Scott
Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Instr Course Lect. 2003;52:733-43.
Musculoskeletal sepsis is infection of bone, joints, muscles, and skin and often occurs after open fractures. Thus, the main objective in the treatment of open fractures in restoration of function and prevention of infection. It is important to consider all open fracture wounds as contaminated. The principles of open fracture treatment include taking appropriate cultures, instituting immediate systemic antibiotic therapy, surgical débridement and wound management, stabilizing the fracture, and early bone grafting when indicated. The open tibial fracture, classified according to Gustilo and Anderson, serves as an exemplary model for musculoskeletal sepsis because this type of injury is described extensively in the literature. Early diagnosis and effective surgical and antibiotic management can control musculoskeletal sepsis, and the suppression of infection may last a lifetime.
肌肉骨骼系统败血症是指骨骼、关节、肌肉和皮肤的感染，常发生于开放性骨折之后。因此，开放性骨折治疗的主要目标是恢复功能和预防感染。将所有开放性骨折伤口视为污染伤口很重要。开放性骨折治疗的原则包括进行适当的培养、立即开始全身抗生素治疗、手术清创和伤口处理、固定骨折以及在有指征时早期植骨。根据 Gustilo 和 Anderson 分类的开放性胫骨骨折是肌肉骨骼系统败血症的典型模型，因为这类损伤在文献中有广泛描述。早期诊断以及有效的手术和抗生素管理可以控制肌肉骨骼系统败血症，而且感染的抑制可能会持续终生。
