Li Shugang, Zhang Jianguo, Li Junwei, Lin Jin, Tian Ye, Weng Xisheng, Qiu Guixing
Department of Orthopedics, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730.
Chin Med Sci J. 2002 Sep;17(3):193-8.
To discuss the causes and treatments of wound infections after scoliosis surgery.
Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively.
All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence.
Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.
探讨脊柱侧弯手术后伤口感染的原因及治疗方法。
回顾924例脊柱侧弯病例，对15例术后感染患者的临床资料进行回顾性分析。
15例均接受了自体骨移植后路脊柱融合内固定术。7例为早期感染，8例为延迟感染。15例均行彻底清创术。抗生素使用时间为10至34天，持续闭式冲洗2至约4周，伤口一期缝合。所有患者平均随访3.5年（2至7.5年），效果良好，无复发。
脊柱侧弯手术矫正后伤口感染主要源于术中播散，尽管宿主相关因素和手术相关因素可能促使其发生。一旦确诊感染，通过及时手术清创、冲洗及合理使用抗生素可取得良好效果。深部感染可能需要取出内固定物。
