Leutenegger A, Bereiter H, Rüedi T
Chirurgische Klinik, Rätisches Kantons- und Regionalspital, Chur.
Helv Chir Acta. 1990 Apr;56(6):835-44.
The acute infection is defined as bacterial growth within the surgical wound, that may occur within days to weeks after initial surgery but before bone union. The chances of complete recovery after an acute soft tissue inflammation are closely related to the interval between initial surgery and first signs of infection, the early recognition of the complication, the type of bacteria involved and the therapeutic measures. The first symptoms of an impending infection are the classical clinical ones of any inflammation: tenderness, swelling and reddening. All imaging procedures are of little or no value. The therapy consists of very aggressive and, if required, repeated wound revisions with debridement of all necrotic tissue, removal of loose bone fragments or loose implant material, wash-outs with antiseptic solutions (e.g. Taurolin) or even deposition of gentamycin beads. Systemic antibiotics may be added temporarily. The in- or external fixation devices must provide stable fracture fixation and the bone as well as the soft tissue envelope must be well vascularized.
急性感染定义为手术伤口内出现细菌生长，这可能在初次手术后数天至数周内发生，但在骨愈合之前。急性软组织炎症后完全恢复的几率与初次手术至感染首发症状之间的间隔、并发症的早期识别、所涉及的细菌类型以及治疗措施密切相关。即将发生感染的最初症状是任何炎症的典型临床症状：压痛、肿胀和发红。所有影像学检查几乎没有价值或毫无价值。治疗包括非常积极的措施，如有必要，反复进行伤口清创，清除所有坏死组织，去除松动的骨碎片或松动的植入物材料，用抗菌溶液（如多粘菌素）冲洗，甚至放置庆大霉素珠。可临时添加全身抗生素。内固定或外固定装置必须提供稳定的骨折固定，骨骼以及软组织包膜必须有良好的血供。
