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肩袖修复术后早期深部感染的处理

Management of early deep infection after rotator cuff repair surgery.

作者信息

Kwon Young W, Kalainov David M, Rose Howard A, Bisson Leslie J, Weiland Andrew J

机构信息

New York University-Hospital for Joint Diseases, New York, USA.

出版信息

J Shoulder Elbow Surg. 2005 Jan-Feb;14(1):1-5. doi: 10.1016/j.jse.2004.04.010.

Abstract

Deep soft-tissue infection occurs infrequently after rotator cuff repair surgery. We retrospectively reviewed the clinical presentation in 14 patients whose rotator cuff repair was complicated by an early deep infection (<6 weeks). The functional outcome after treatment in 12 of these patients was analyzed at a mean follow-up of 37.5 months (range, 11-122 months). The diagnosis of infection was most often made within 3 weeks from the date of surgery (mean, 18 days; range, 3-41 days). Common presenting symptoms included localized wound erythema and drainage. The blood leukocyte counts were usually normal, but the erythrocyte sedimentation rates and C-reactive protein levels were elevated. A mean of 2.6 surgical debridements were required to clean the wound effectively in each case. Eight of twelve patients were dissatisfied at final assessment. Most patients reported reasonably good relief of pain, but they had residual shoulder stiffness and weakness. Retention of suture anchors in the humeral head did not preclude successful eradication of the infection.

摘要

肩袖修复术后深部软组织感染并不常见。我们回顾性分析了14例肩袖修复术后并发早期深部感染(<6周)患者的临床表现。其中12例患者在平均37.5个月(范围11 - 122个月)的随访期内接受治疗后的功能结果进行了分析。感染诊断大多在术后3周内作出(平均18天;范围3 - 41天)。常见症状包括局部伤口红斑和引流。血液白细胞计数通常正常,但血沉率和C反应蛋白水平升高。每例患者平均需要2.6次手术清创才能有效清洁伤口。12例患者中有8例在最终评估时不满意。大多数患者报告疼痛得到了较好缓解,但仍有残留的肩部僵硬和无力。肱骨头上的缝合锚钉保留并不妨碍成功根除感染。

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