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急性胸壁感染:手术部位感染、坏死性软组织感染和胸锁关节感染。

Acute Chest Wall Infections: Surgical Site Infections, Necrotizing Soft Tissue Infections, and Sternoclavicular Joint Infection.

作者信息

Schipper Paul, Tieu Brandon H

机构信息

Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road L353, Portland, OR 97239, USA.

Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road L353, Portland, OR 97239, USA.

出版信息

Thorac Surg Clin. 2017 May;27(2):73-86. doi: 10.1016/j.thorsurg.2017.01.001.

Abstract

Acute chest wall infections are uncommon and share similar risk factors for infection at other surgical sites. Smoking cessation has been shown to decrease the risk of surgical site infection. Depending on the depth of infection and/or involvement of the organ space, adequate therapy involves antibiotics and drainage. Early diagnosis and debridement of necrotizing soft tissue infections is essential to reduce mortality. Sternoclavicular joint infections require surgical debridement, en bloc resection, and antibiotic therapy. A standard approach to wound closure after resection has yet to be established. Vacuum-assisted closure is a valuable adjunct to standard therapy.

摘要

急性胸壁感染并不常见,与其他手术部位的感染有相似的危险因素。已证明戒烟可降低手术部位感染的风险。根据感染深度和/或器官间隙受累情况,适当的治疗包括使用抗生素和引流。早期诊断和清创坏死性软组织感染对于降低死亡率至关重要。胸锁关节感染需要手术清创、整块切除和抗生素治疗。切除术后伤口闭合的标准方法尚未确立。负压封闭引流是标准治疗的一种有价值的辅助手段。

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