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烧伤外科感染预防措施

Measures for Preventing Infection in Burn Surgery.

作者信息

Leypold Tim, Schäfer Benedikt, Beier Justus P

机构信息

Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen, Germany.

出版信息

Surg Technol Int. 2022 Nov 15;41:45-51. doi: 10.52198/22.STI.41.WH1604.

Abstract

The skin is the largest human organ and an important barrier to protect against the environment. Burns damage the skin and thus destroy this anatomical barrier. This makes initially sterile wounds susceptible to colonization by pathogenic germs. In severely burned patients, immune competence decreases as part of the burn disease. Sepsis and multiple organ failure as a result of infection are the main causes of death in this cohort. Therefore, prevention and recognition of infections as well as surgical treatment and targeted anti-infective therapy are of great importance. In this article, we present up-to-date solutions for the treatment of burn wounds by means of plastic and reconstructive surgery to minimize the risk of infection. We demonstrate the principles of infection defense by the skin barrier. We outline the principles of burns and how to perform an appropriate diagnosis and therapy, from outpatient therapy to intensive care therapy, depending on the severity. We address the typical bacteria responsible for wound infections in severely burned patients and how to prevent and treat them. We also describe the hygiene measures that must be used in a severe burn unit to reduce the risk of complications such as infection and improve patient survival.

摘要

皮肤是人体最大的器官,也是抵御外界环境的重要屏障。烧伤会损害皮肤,进而破坏这一解剖学屏障。这使得原本无菌的伤口容易被致病菌定植。在严重烧伤患者中,免疫功能会作为烧伤疾病的一部分而下降。感染导致的脓毒症和多器官功能衰竭是该群体死亡的主要原因。因此,预防和识别感染以及手术治疗和针对性抗感染治疗至关重要。在本文中,我们介绍了通过整形和重建手术治疗烧伤创面的最新解决方案,以将感染风险降至最低。我们阐述了皮肤屏障的抗感染原理。我们概述了烧伤的原则以及如何根据严重程度进行适当的诊断和治疗,从门诊治疗到重症监护治疗。我们讨论了导致严重烧伤患者伤口感染的典型细菌以及如何预防和治疗它们。我们还描述了在严重烧伤病房必须采取的卫生措施,以降低感染等并发症的风险并提高患者生存率。

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