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浸润性伤口负压封闭联合局部两性霉素治疗跟腱毛霉菌感染

Infiltrating Wound Vacuum-Assisted Closure With Topical Amphotericin for Mucormycosis Infection of the Achilles Tendon.

作者信息

Romo Marco A, Leach Garrison, Reid Christopher M, Dean Riley A, Suliman Ahmed

机构信息

Tufts University School of Medicine, Boston, Massachusetts.

San Diego Veterans Affairs Medical Center, Department of Plastic Surgery, California.

出版信息

Fed Pract. 2023 Feb;40(2):47-49. doi: 10.12788/fp.0359. Epub 2023 Feb 16.

Abstract

BACKGROUND

The rarity and heterogeneity of mucormycosis make treatment variable, and no prospective or randomized clinical trials exist in plastic surgery literature. The use of wound vacuum-assisted closure in combination with the instillation of amphotericin B to treat cutaneous mucormycosis is not well documented.

CASE PRESENTATION

A 53-year-old man underwent left Achilles tendon reconstruction with allograft after a complete tear during exercise. About 1 week after the operation, he began having incisional breakdown later found to be secondary to mucormycosis infection, prompting presentation to an emergency department. The use of negative pressure wound therapy with wound vacuum-assisted closure and intervals of instilling amphotericin B facilitated infection control in this lower extremity mucormycosis infection.

CONCLUSIONS

Patients with a localized mucormycosis infection may benefit from treatment with an instillation wound vacuum-assisted closure with topical amphotericin B as presented in this case study.

摘要

背景

毛霉菌病的罕见性和异质性使得治疗方法各不相同,整形外科学文献中尚无前瞻性或随机临床试验。伤口负压封闭引流联合两性霉素B灌注治疗皮肤毛霉菌病的应用尚无充分文献记载。

病例介绍

一名53岁男性在运动中跟腱完全断裂后接受了同种异体肌腱移植重建左跟腱手术。术后约1周,他开始出现切口裂开,后来发现是由毛霉菌病感染引起的,遂前往急诊科就诊。采用伤口负压封闭引流及间隔灌注两性霉素B的方法有助于控制该下肢毛霉菌病感染。

结论

如本病例研究所示,局限性毛霉菌病感染患者可能受益于伤口负压封闭引流联合局部应用两性霉素B的治疗。

相似文献

6
[Vacuum therapy for deep wound infection after Achilles tendon repair].[跟腱修复术后深部伤口感染的负压治疗]
Z Orthop Unfall. 2009 Jul-Aug;147(4):433-8. doi: 10.1055/s-0029-1185348. Epub 2009 Aug 19.

引用本文的文献

本文引用的文献

1
Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications.负压伤口治疗:作用机制与临床应用
Semin Plast Surg. 2021 Aug;35(3):164-170. doi: 10.1055/s-0041-1731792. Epub 2021 Sep 10.
3
Therapy of Mucormycosis.毛霉菌病的治疗
J Fungi (Basel). 2018 Jul 31;4(3):90. doi: 10.3390/jof4030090.
5
Fungal skin and soft tissue infections.真菌性皮肤和软组织感染。
Curr Opin Infect Dis. 2016 Apr;29(2):124-30. doi: 10.1097/QCO.0000000000000252.
6
Pathogenesis of mucormycosis.毛霉病的发病机制。
Clin Infect Dis. 2012 Feb;54 Suppl 1(Suppl 1):S16-22. doi: 10.1093/cid/cir865.
9
New techniques in wound management: vacuum-assisted wound closure.伤口处理的新技术:负压封闭引流技术
J Am Acad Orthop Surg. 2002 Sep-Oct;10(5):303-11. doi: 10.5435/00124635-200209000-00002.
10
Primary cutaneous mucormycosis: guide to surgical management.原发性皮肤毛霉病:手术治疗指南
Ann Plast Surg. 2002 Oct;49(4):385-90. doi: 10.1097/00000637-200210000-00009.

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