Hau T, Förster E
Allgemeinchirurgische Klinik, Nord-West-Krankenhauses Sanderbusch, Sande.
Zentralbl Chir. 1990;115(9):521-41.
Soft tissue infections are caused by a multitude of bacteria. Their pathogenicity depends on the ability to adhere to surfaces, certain characteristics of the cell wall, exoenzymes or exotoxins, and endotoxins. Because etiologic classification of soft tissue infections is not satisfactory, we propose a clinical classification. 1. Abscesses are caused by staphylococci (carbuncle or suppurative hydroadenitis) or by polymicrobial infections (most subcutaneous abscesses). They are treated by incision and drainage and primary closure of the skin after drainage and curettage is often successful. Only in special cases are antibiotics indicated. 2. Cellulitis mostly caused by streptococci responds well to antibiotic therapy without surgery. 3. Ulcerative lesions i.e. pseudomonal gangrene and Meleney's gangrene need specific antibiotic therapy and complete excision with delayed grafting.
软组织感染由多种细菌引起。它们的致病性取决于附着于表面的能力、细胞壁的某些特性、外酶或外毒素以及内毒素。由于软组织感染的病因分类并不令人满意,我们提出一种临床分类方法。1. 脓肿由葡萄球菌(痈或化脓性汗腺炎)或多微生物感染(大多数皮下脓肿)引起。通过切开引流进行治疗,引流和刮除后皮肤一期缝合通常会成功。仅在特殊情况下才使用抗生素。2. 蜂窝织炎大多由链球菌引起,对抗生素治疗反应良好,无需手术。3. 溃疡性病变,即铜绿假单胞菌坏疽和梅勒尼坏疽,需要特定的抗生素治疗并进行彻底切除,延迟植皮。