Department of Plastic and Reconstructive Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Plastic and Reconstructive Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Asian J Surg. 2014 Jan;37(1):24-9. doi: 10.1016/j.asjsur.2013.07.006. Epub 2013 Aug 22.
The aim of this study was to investigate the proper treatment of infected median sternotomy wounds.
A retrospective study was conducted to investigate the proper treatment of infected median sternotomy wounds on patients with sternal wound infections from January 2007 to July 2009. The characteristics of the sternal infections and the treatment outcomes were analysed.
Ninety-seven patients with sternal wound infections were treated. A total of 32 patients acquired the infection within one month after open-heart surgery, 10 patients got the infection one to two months after the surgery, and 1 patient died two days after debridement. There were 54 patients who acquired the infection beyond two months post-surgery, while 1 patient died on the day before the operation. One patient received four cycles of wound debridement, 18 patients received two cycles and 78 patients only received one cycle. A total of 14 patients received a vacuum-assisted closure treatment. There were 73 patients who had surgery for repair of muscle flaps, 1 patient for breast tissue flap, 63 patients for pectoralis major muscle flap, and 9 patients with rectus abdominis muscle flap. There were 12 patients who received a transverse plate fixation of the sternum with titanium plating.
A positive prognosis can be obtained by the algorithm treatment based on the onset and depth of the sternal infection.
本研究旨在探讨感染性正中胸骨切开术后的治疗方法。
回顾性研究 2007 年 1 月至 2009 年 7 月正中胸骨切开术后胸骨伤口感染患者的治疗方法。分析胸骨感染的特征及治疗结果。
97 例胸骨伤口感染患者接受了治疗。术后 1 个月内发生感染 32 例,1-2 个月内发生感染 10 例,1 例患者在清创后 2 天死亡。术后 2 个月以上发生感染 54 例,1 例患者在手术前一天死亡。1 例患者接受了 4 次清创,18 例患者接受了 2 次,78 例患者仅接受了 1 次。14 例患者接受了负压辅助闭合治疗。73 例患者行肌瓣修复手术,1 例患者行乳房组织瓣,63 例患者行胸大肌瓣,9 例患者行腹直肌瓣。12 例患者行胸骨横板钛板固定。
根据胸骨感染的发病时间和深度,采用算法治疗可获得良好的预后。