手部肿胀未消退：考虑感染因素。
Unresolved swelling of the hand: Think of infection.
作者信息
Drakou A, Psifis M, Mitrou A, Zygoggianis K, Argyropoulou Ourania
机构信息
Orthopaedic Department, Laiko Hospital University of Athens, Greece.
University Department of Pathologic Physiology, Kapodistrian University of Athens, Laiko Hospital University of Athens, Greece.
出版信息
Trauma Case Rep. 2020 Jan 23;26:100283. doi: 10.1016/j.tcr.2020.100283. eCollection 2020 Apr.
The surgical intervention and adjuvant locally applied measures to reduce the impact of a severe cutaneous hand infection caused by in a 48-year-old diver, receiving anti-TNFa (anti-tumor necrosis factor αlpha) treatment are presented herein. Careful surgical intervention- considered controversial so far-and lateral thinking are essential for the outcome of musculoskeletal infections caused by M marinum. Locally applied disinfection strategies inspired from fields other than medical (e.g. environmental biology) and clearly set surgery goals - aiming at optimizing tissue sampling, antibiotic penetration, decompression while preventing iatrogenic spread are discussed.
本文介绍了对一名48岁潜水员因[未提及具体病菌]导致的严重手部皮肤感染所采取的手术干预及局部辅助治疗措施，该潜水员正在接受抗TNFα（抗肿瘤坏死因子α）治疗。谨慎的手术干预——迄今为止一直存在争议——以及横向思维对于海分支杆菌引起的肌肉骨骼感染的治疗结果至关重要。讨论了从医学以外领域（如环境生物学）获得灵感的局部消毒策略，以及明确设定的手术目标——旨在优化组织采样、抗生素渗透、减压同时防止医源性传播。
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