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坏死性软组织感染

Necrotizing soft tissue infections.

作者信息

Cainzos Miguel, Gonzalez-Rodriguez Francisco J

机构信息

Department of Surgery, Hospital Clinico Universitario, Medical School, Santiago de Compostela, Spain.

出版信息

Curr Opin Crit Care. 2007 Aug;13(4):433-9. doi: 10.1097/MCC.0b013e32825a6a1b.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to consider recent advances in the definition, pathogenesis, diagnostic criteria, and treatment of necrotizing soft tissue infections.

RECENT FINDINGS

The efficacy of early surgical debridement combined with antimicrobial therapy, close monitoring and physiologic support is strongly demonstrated. Novel therapeutic strategies including vacuum-assisted wound-closure therapy and intravenous immunoglobulin have been described.

SUMMARY

Necrotizing soft-tissue infection is a rare infection of the subcutaneous tissue and fascia that is often associated with sepsis and can progress rapidly with a possible fatal outcome. Although the cause is not yet understood fully, patients often have a prior history of a small, trivial trauma, wound, or scratch. Establishing the diagnosis can be the main challenge in treating patients, and knowledge of all available tools is key for early and accurate diagnosis.

摘要

综述目的

本综述旨在探讨坏死性软组织感染在定义、发病机制、诊断标准及治疗方面的最新进展。

最新发现

有力证明了早期手术清创联合抗菌治疗、密切监测及生理支持的有效性。已描述了包括负压伤口封闭疗法和静脉注射免疫球蛋白在内的新型治疗策略。

总结

坏死性软组织感染是一种罕见的皮下组织和筋膜感染,常与脓毒症相关,可迅速进展并可能导致致命后果。尽管病因尚未完全明确,但患者通常有轻微创伤、伤口或擦伤的既往史。确立诊断可能是治疗患者的主要挑战,了解所有可用工具是早期准确诊断的关键。

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