Zumkeller M, Gaab M R
Neurochirurgische Klinik der Medizinischen Hochschule Hannover.
Neurochirurgia (Stuttg). 1987 Sep;30(5):143-8. doi: 10.1055/s-2008-1054083.
Treatment of infections after neurosurgical operations at the head and vertebral column is lengthy and stressful for the patient. Hence, we implanted--as has been routine in septic bone surgery for a long time--carriers of antibiotics for local antibiotic therapy in the form of Septopal chains. The course of treatment and the results obtained in 16 patients are presented. In all patients the wound cavities were filled with Septopal chains after débridement. In the course of 6-12 days the chains projecting from the skin by a stab incision were extracted sphere by sphere. The treated wound healed immediately in 14 patients; healing was delayed in 2 patients, but there were no complications. Since the use of Septopal chains results in local gentamicin levels which are so high that the conventional classification of germs into gentamicin-sensitive/gentamicin-resistant is of minor importance, the wounds healed without complications even in those patients where the germs had been classified as "resistant" in the routine antibiogram. Thus, Septopal offers the advantage of primary wound closure without secondary contamination or scatter into the environment (intensive-care ward!), shorter treatment time, reduced stress for the patient and more rapid mobilisation.
颅脑和脊柱神经外科手术后感染的治疗过程漫长，且让患者倍感压力。因此，我们植入了抗生素载体——长期以来在化脓性骨外科手术中作为常规操作——以Septopal链的形式进行局部抗生素治疗。本文介绍了16例患者的治疗过程及结果。所有患者在清创后伤口腔内均填充了Septopal链。在6至12天的过程中，通过刺创切口从皮肤伸出的链节逐个球体地被取出。14例患者的治疗伤口立即愈合；2例患者愈合延迟，但未出现并发症。由于使用Septopal链会使局部庆大霉素水平升高，以至于按照常规将细菌分为庆大霉素敏感/耐药已无太大意义，因此即使在常规抗菌谱中细菌被分类为“耐药”的患者中，伤口也能顺利愈合且无并发症。因此，Septopal具有无需二次污染或向环境（重症监护病房！）扩散即可实现一期伤口闭合的优势，治疗时间更短，患者压力减轻，活动恢复更快。
