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手部感染:回顾性分析。

Hand infections: a retrospective analysis.

机构信息

Department of Orthopaedic Surgery, The University of Arizona , Tucson, AZ , USA.

Arizona Health Sciences Library, The University of Arizona , Tucson, AZ , USA.

出版信息

PeerJ. 2014 Sep 2;2:e513. doi: 10.7717/peerj.513. eCollection 2014.

Abstract

Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management. Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s) and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed. Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications. Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

摘要

目的。手部感染较为常见,通常是由于未得到治疗的创伤所致。在这项回顾性研究中,我们报告了需要手术引流的手部感染病例,以评估患者的人口统计学特征、感染原因、临床过程和临床管理。

方法。对一年间因手部感染(不包括术后感染)接受切开引流术治疗的患者的病历进行了回顾。评估了患者的人口统计学特征、既往病史、感染部位和病因、感染发病、住院、手术干预以及住院天数之间的间隔、革兰氏染色和培养、抗生素选择、并发症和结局。

结果。大多数感染是由裂伤引起的,最常见的感染部位是手掌或手背。平均住院时间为 6 天。耐甲氧西林金黄色葡萄球菌、β-溶血性链球菌和甲氧西林敏感金黄色葡萄球菌是最常见的培养微生物。头孢菌素类、克林霉素、阿莫西林/克拉维酸、青霉素、万古霉素和复方磺胺甲噁唑是主要的抗生素选择。截肢和挛缩是主要的并发症。

结论。手术联合药物治疗是治疗的关键,大多数软组织感染无需进一步治疗即可痊愈。通过及时、适当的治疗,大多数手部感染患者可以完全治愈。

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