Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Acta Otorhinolaryngol Ital. 2022 Aug;42(4):372-379. doi: 10.14639/0392-100X-N1985.
This study aims to assess the frequency, bacteriology, biofilm characteristics and management of skin flap infection (SFI) following cochlear implantation (CI).
The study enrolled 1,251 patients receiving CI in the First Affiliated Hospital of Fujian Medical University between August 2001 and March 2021. Scanning electron microscopy (SEM) was utilised to characterise the aetiology of infection. A proposed classification system was applied to optimise treatments for post-operative skin flap infection.
After CI, SFI was reported in 16 patients (1.28%) and occurred more frequently in patients under 6 years of age. Of all SFI cases was the most common pathogen for flap infection, with 8 cases (50%) and bacterial biofilm was evident within the jelly-like substance on the surface of implanted devices in SFI patients. A two-stage classification was proposed to optimise the treatment schemes. Conservative therapy was recommended for stage I cases and surgical treatment for stage II patients.
Paediatric patients are more susceptible to SFI after CI, which may be attributed to the formation of bacterial biofilm. The proposed classification can facilitate the management of SFI.
本研究旨在评估 1,251 例接受 Cochlear 植入术（CI）患者的皮肤瓣感染（SFI）的发生率、细菌学、生物膜特征和管理。
本研究纳入了 2001 年 8 月至 2021 年 3 月期间在福建医科大学第一附属医院接受 CI 的 1,251 例患者。扫描电子显微镜（SEM）用于感染病因学的特征分析。采用提出的分类系统来优化术后皮肤瓣感染的治疗。
在 CI 后，16 例（1.28%）患者报告发生了 SFI，且年龄在 6 岁以下的患者更易发生。在所有 SFI 病例中， 是最常见的瓣感染病原体，8 例（50%）患者存在细菌生物膜，且在 SFI 患者植入设备表面的果冻状物质中存在。提出了一种两阶段分类来优化治疗方案。对于 I 期病例建议采用保守治疗，对于 II 期病例建议采用手术治疗。
小儿患者在接受 CI 后更易发生 SFI，这可能与细菌生物膜的形成有关。提出的分类可以促进 SFI 的管理。
