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胸骨深部伤口感染:诊断、治疗与预防。

Deep Sternal Wound Infection: Diagnosis, Treatment and Prevention.

机构信息

Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore.

Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore.

出版信息

J Cardiothorac Vasc Anesth. 2020 Jun;34(6):1602-1613. doi: 10.1053/j.jvca.2019.09.019. Epub 2019 Sep 18.

Abstract

Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of DSWI is reported to be between 0.2% and 3%. Identifying high-risk patients and strategies to optimize risk factors plays an important role in reducing the incidence of DSWI. Management of DSWI can be complex and may require a multidisciplinary team approach involving infectious disease specialists, microbiologists, as well as cardiothoracic and plastic surgeons. Early detection, appropriate antibiotic treatment, aggressive surgical debridement, and use of regional muscle flaps have significantly improved treatment outcomes.

摘要

胸骨深部伤口感染(DSWI)是心脏手术中正中胸骨切开术罕见但潜在破坏性的并发症。DSWI 的发生率据报道为 0.2%至 3%。确定高危患者和优化风险因素的策略对于降低 DSWI 的发生率至关重要。DSWI 的治疗可能很复杂,可能需要多学科团队的方法,包括传染病专家、微生物学家以及心胸和整形外科医生。早期发现、适当的抗生素治疗、积极的手术清创和使用区域性肌肉皮瓣显著改善了治疗效果。

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