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应用含银的负压伤口疗法治疗坏死性筋膜炎。

Use of negative pressure wound therapy with silver base dressing for necrotizing fasciitis.

机构信息

Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Wound Ostomy Continence Nurs. 2011 Jul-Aug;38(4):449-52. doi: 10.1097/WON.0b013e31821e43f1.

Abstract

BACKGROUND

Necrotizing fasciitis is a life-threatening infection requiring urgent surgical and medical therapy. Hemodynamic stabilization and antimicrobial therapy precede aggressive surgical excision of necrotic tissue, which should be performed as soon as possible. The rapidly spreading infection and aggressive surgical intervention create challenges for wound management. Multiple dressings are available to address the various challenges associated with management of these wounds; this article discusses negative pressure therapy and antimicrobial dressings in the management of Fournier's gangrene, a form of necrotizing fasciitis that involves tissue of the genital or perianal areas.

CASE PRESENTATION

This article reviews the case of a 56-year-old man with fever, tachycardia, and perianal pain associated with necrotizing fasciitis. Extensive surgical debridement was done on the day of admission. After several irrigations, the wound was dressed by negative pressure wound therapy with a silver dressing that minimized hospital stay and enabled early reconstruction.

CONCLUSION

We found that negative pressure wound therapy with a silver-based dressing promoted wound healing and provided a solid matrix for surgical reconstruction.

摘要

背景

坏死性筋膜炎是一种危及生命的感染,需要紧急的手术和药物治疗。血流动力学稳定和抗菌治疗先于坏死组织的积极切除,应尽快进行。快速扩散的感染和积极的手术干预给伤口管理带来了挑战。有多种敷料可用于解决这些伤口管理相关的各种挑战;本文讨论了负压治疗和抗菌敷料在治疗 Fournier 坏疽(一种涉及生殖器或肛周区域组织的坏死性筋膜炎)中的应用。

病例介绍

本文回顾了一位 56 岁男性的病例,他因发热、心动过速和肛周疼痛而患有坏死性筋膜炎。入院当天进行了广泛的清创手术。经过几次冲洗后,使用银敷料的负压伤口治疗对伤口进行了处理,这最大限度地减少了住院时间并实现了早期重建。

结论

我们发现,银基敷料的负压伤口治疗促进了伤口愈合,并为手术重建提供了坚实的基质。

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