Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
Biomed Res Int. 2020 Aug 4;2020:5230763. doi: 10.1155/2020/5230763. eCollection 2020.
Although the incidence and mortality of complicated skin and soft tissue infections have decreased, this infection is still relatively frequent and can be associated with lethal complications. In this study, the authors present our clinical experience of patients with complicated posterior cervical skin and soft tissue infections (CPCSSTIs) diagnosed and treated in a reconstructive unit in northeastern China.
A retrospective chart review of patients diagnosed with CPCSSTIs from January 2009 to December 2018 was performed. To make the results objective and convincing, a data analysis was performed relating to demographic characteristics, clinical presentation, predisposing factor, bacterial culture, laboratory and radiographic evaluations, diagnostic clues, management, and complications as well as the clinical course and outcome.
During the ten-year period, there were 174 consecutive patients admitted to our reconstructive center with final diagnosis of CPCSSTIs included. All the patients were adults, and the majority were male (67.2%). The patient's mean age was 51.3 years (range, 15-88 years). There were 114 patients (65.5%) that had associated systemic diseases, with diabetes mellitus (40.2%) as the most common predisposing factor. Common presented clinical symptoms were pain (90.8%), swelling (85.1%), and erythema (77%) of the neck. Surgical treatment was performed in all the patients, and most of them (83.9%) received the first surgery within 24 h. The most commonly isolated pathogen was (30%). Vancomycin (21.3%) was the most commonly used antibiotics, followed by cefepime (18.4%). All the patients survived and were discharged with a mean duration of hospitalization of 28.7 days. Those patients with predisposing factors (31.4 ± 12.35 days) or complications (41.0 ± 12.5 days) tended to have a longer hospital stay. The mean total costs of admission per patient were 47 644 RMB.
This study highlights the high cost burden of CPCSSTI patients. Those patients with predisposing factors or complications tended to have a longer hospital stay.
尽管复杂性皮肤和软组织感染的发病率和死亡率有所下降，但这种感染仍然相对常见，并且可能伴有致命的并发症。在本研究中，作者介绍了在中国东北地区的一个重建单位诊断和治疗的复杂性颈后皮肤和软组织感染（CPCSSTIs）患者的临床经验。
对 2009 年 1 月至 2018 年 12 月期间在 CPCSSTIs 诊断和治疗的患者进行回顾性图表分析。为了使结果客观可信，对人口统计学特征、临床表现、诱发因素、细菌培养、实验室和影像学评估、诊断线索、管理和并发症以及临床病程和结局进行了数据分析。
在十年期间，共有 174 例连续患者被收入我们的重建中心，最终诊断为 CPCSSTIs。所有患者均为成年人，其中大多数为男性（67.2%）。患者的平均年龄为 51.3 岁（范围 15-88 岁）。有 114 例（65.5%）患者伴有系统性疾病，其中糖尿病（40.2%）是最常见的诱发因素。常见的临床表现为疼痛（90.8%）、肿胀（85.1%）和颈部红斑（77%）。所有患者均接受手术治疗，其中大多数（83.9%）在 24 小时内接受首次手术。最常分离的病原体是金黄色葡萄球菌（30%）。万古霉素（21.3%）是最常用的抗生素，其次是头孢吡肟（18.4%）。所有患者均存活并出院，平均住院时间为 28.7 天。有诱发因素的患者（31.4 ± 12.35 天）或并发症的患者（41.0 ± 12.5 天）住院时间往往更长。每位患者的平均住院费用为 47644 元。
本研究强调了复杂性皮肤和软组织感染患者的高费用负担。有诱发因素或并发症的患者住院时间往往更长。
