严重水相关皮肤及软组织脓毒症的诊断与管理：文献综述
Diagnosis and Management of Severe Water-Related Skin and Soft Tissue Sepsis: A Summative Review of the Literature.
作者信息
Naidoo Shanisa, Zwane Arnold M, Paruk Ahmed, Hardcastle Timothy Craig
机构信息
Department of Surgery, University of KwaZulu-Natal, Durban 4001, South Africa.
Trauma and Burn Service, Inkosi Albert Luthuli Central Hospital, Mayville 4058, South Africa.
出版信息
Diagnostics (Basel). 2023 Jun 23;13(13):2150. doi: 10.3390/diagnostics13132150.
BACKGROUND
Skin and soft tissue infections (SSTIs) are common presentations in the emergency department. However, this is less common after contact with contaminated saltwater or freshwater. This review presents the diagnosis and management of water-related soft tissue sepsis in this vulnerable and difficult-to-treat subgroup of necrotizing soft tissue sepsis.
METHODS
A summative literature overview is presented regarding bacterial and fungal SSTI after contact with contaminated water, with practical diagnostic and management aspects.
RESULTS
The literature indicates that these wounds and infections remain difficult to treat. An approach using appropriate diagnostic tools with both medical and surgical management strategies is provided.
CONCLUSIONS
SSTIs due to water contamination of wounds involve unusual organisms with unusual resistance patterns, and require a nuanced and directed diagnostic approach with an adaptation of the usual antibiotic or antifungal selection to achieve a successful cure, along with aggressive debridement and wound care.
背景
皮肤和软组织感染（SSTIs）是急诊科的常见病症。然而，接触受污染的盐水或淡水后发生这种感染的情况较少见。本综述介绍了在这种易感染且难以治疗的坏死性软组织脓毒症亚组中与水相关的软组织脓毒症的诊断和管理。
方法
本文对接触受污染水后发生的细菌性和真菌性SSTI进行了总结性文献综述，并阐述了实际的诊断和管理方面。
结果
文献表明，这些伤口和感染仍然难以治疗。本文提供了一种使用适当诊断工具并结合医疗和手术管理策略的方法。
结论
因伤口被水污染导致的SSTIs涉及具有不寻常耐药模式的不常见病原体，需要采用细致且有针对性的诊断方法，调整常规的抗生素或抗真菌药物选择以实现成功治愈，同时进行积极的清创和伤口护理。
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