Kajikawa Akiyoshi, Ueda Kazuki, Katsuragi Yoko, Iida Shoko
Department of Plastic and Reconstructive Surgery, Fukushima Medical University, 1, Hikarigaoka, Fukushima, 960-1295, Japan.
J Plast Reconstr Aesthet Surg. 2009 Mar;62(3):e69-72. doi: 10.1016/j.bjps.2008.09.027. Epub 2008 Dec 16.
When tissue expander sites are infected, it often results in removal of the expander. To salvage the infected expander and achieve full expansion, we devised a new continuous irrigation method with intermittent aspiration. In this method, the continuous irrigation of the tissue expander pocket was performed without removal of the expander. Saline was continuously infused at 50 ml h(-1) via the IVH catheter and intermittent aspiration was done at 10 cm H(2)O negative pressure via the suction drainage tube for 3 min per hour until the infection was under control. We performed this method on two cases of infection of tissue expander sites and salvaged both expanders. After controlling the infection, reconstructions were successfully performed with enough skin expansion. In this method, the expander left in the pocket acts not only in maintaining the expanded pocket but also helps in irrigating the inner surface of the skin pocket. This method can perform effective irrigation with a relatively small amount of saline (1200 ml per day) and salvage the tissue expander.
当组织扩张器部位发生感染时,常常会导致扩张器被取出。为了挽救感染的扩张器并实现充分扩张,我们设计了一种新的持续冲洗并间断抽吸的方法。在该方法中,在不移除扩张器的情况下对组织扩张器腔隙进行持续冲洗。通过颅内压监测导管以50 ml h(-1)的速度持续输注生理盐水,并通过吸引引流管以10 cm H(2)O的负压每小时进行3分钟的间断抽吸,直至感染得到控制。我们对两例组织扩张器部位感染的病例采用了该方法,成功挽救了两个扩张器。在控制感染后,通过充分的皮肤扩张成功进行了重建。在该方法中,留在腔隙内的扩张器不仅起到维持扩张腔隙的作用,还有助于冲洗皮肤腔隙的内表面。该方法能用相对少量的生理盐水(每天1200 ml)进行有效冲洗,并挽救组织扩张器。