Gudbjartsson Tomas, Jeppsson Anders
Department of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland.
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital.
Laeknabladid. 2019 Apr;105(4):177-182. doi: 10.17992/lbl.2019.04.227.
Wound infections are common complications after open heart surgery, both in the sternotomy and vein harvest wound. Fortunately, most of these infections are superficial and respond to minor wound debridement and antibiotics, however, 1-3% of patients develop deep sternal wound infection with mediastinis; an infection that can be fatal. Late infections with sternocutaneous fistulas are encountered less often, but also represent a complex surgical problem. The vein harvest site is the most common site for wound infections after cardiac surgery and these infections result in significant patient morbidity and increases health-care costs. This evidence-based review covers etiology, risk factors, prevention and treatment of wound infections following open heart surgery with special focus on advances in treatment, especially negative-pressure wound therapy.
伤口感染是心脏直视手术后常见的并发症，在胸骨切开伤口和取静脉伤口处均会发生。幸运的是，这些感染大多为表浅性，通过轻微的伤口清创和使用抗生素即可治愈。然而，1%至3%的患者会发生深部胸骨伤口感染并伴有纵隔炎，这种感染可能是致命的。胸骨皮肤瘘的晚期感染较少见，但也是一个复杂的外科问题。取静脉部位是心脏手术后伤口感染最常见的部位，这些感染会导致患者出现严重的发病率，并增加医疗保健成本。这篇基于证据的综述涵盖了心脏直视手术后伤口感染的病因、危险因素、预防和治疗，特别关注治疗方面的进展，尤其是负压伤口治疗。
