Akinyoola A L, Ojo O D, Oginni L M
Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nirgeria.
J Wound Care. 2008 May;17(5):202, 204-6. doi: 10.12968/jowc.2008.17.5.29150.
To identify the microbial pathogens responsible for amputation wound infections, their distribution and antibiotic-sensitivity patterns.
Consecutive patients who had limb amputations from April 2002 to March 2006 in an Nigerian hospital were recruited into this prospective observational study. The patients' demographic features, indications for amputation, microbiology of stump wound infections and the effects on length of hospital stay were reported.
Fifty-seven patients (mean age 34.6 +/- 19.2 years) had amputations in 58 limbs. Trauma leading to limb gangrene following treatment by traditional bone setters was the most common indication for amputation (64%). Approximately 76% of the amputations were in the lower limbs. Wound infection occurred in 48% of the stumps, of which 71% had been amputated because of a trauma injury. Pseudomonas aeruginosa was the most commonly isolated pathogen (40%).There was a very low correlation between the aetiologic bacterial agents and the age of patient, source of referral, indication for amputation and level of amputation. Amputation wound infections significantly prolonged the patients' length of hospital stay (p=0.002).
Amputation wound infection constitutes a serious morbidity in our practice. Most of the causes are preventable.
确定导致截肢伤口感染的微生物病原体、它们的分布及抗生素敏感性模式。
选取2002年4月至2006年3月在一家尼日利亚医院接受肢体截肢的连续患者纳入这项前瞻性观察研究。报告了患者的人口统计学特征、截肢指征、残端伤口感染的微生物学情况以及对住院时间的影响。
57例患者（平均年龄34.6±19.2岁）接受了58例肢体截肢手术。经传统接骨师治疗后导致肢体坏疽的创伤是最常见的截肢指征（64%）。约76%的截肢发生在下肢。48%的残端发生了伤口感染，其中71%因创伤性损伤而截肢。铜绿假单胞菌是最常分离出的病原体（40%）。致病细菌与患者年龄、转诊来源、截肢指征和截肢部位之间的相关性非常低。截肢伤口感染显著延长了患者的住院时间（p = 0.002）。
在我们的医疗实践中，截肢伤口感染是一种严重的发病情况。大多数病因是可预防的。
