Purdue G F, Hunt J L
Am J Surg. 1986 Sep;152(3):257-9. doi: 10.1016/0002-9610(86)90252-7.
Chondritis may occur in up to 25 percent of burned ears and commonly follows a superficial partial-thickness injury. The onset is usually insidious and often delayed. Prevention is the key, as the treatment of an established infection frequently leads to disastrous consequences. Herein, we have reviewed 136 consecutive inpatients with burns of the ear. The burned ear was managed by careful, twice daily washing with minimal debridement, frequent application of mafenide acetate, and avoidance of pressure on the affected ear. Exposed cartilage was treated in the same manner, with surgical debridement of grossly nonviable tissue followed by skin grafting as necessary. There were no cases of chondritis in the series. Recognition of the potential for chondritis in any burn of the ear underscores the need for careful wound management, even for relatively minor injuries. The extreme difficulty of prospectively identifying the ear that will become infected coupled with the risks associated with more aggressive methods of prevention make these methods unwarranted.
耳部软骨炎在高达25%的耳部烧伤患者中可能发生,通常继发于浅表性部分厚度损伤之后。发病通常隐匿且常延迟出现。预防是关键,因为已确诊感染的治疗往往会导致灾难性后果。在此,我们回顾了136例连续的耳部烧伤住院患者。耳部烧伤的处理方法是小心地每日清洗两次,尽量减少清创,频繁应用醋酸磺胺米隆,并避免对患耳施加压力。暴露的软骨以同样方式处理,对明显无活力的组织进行手术清创,必要时随后进行植皮。该系列中无软骨炎病例。认识到任何耳部烧伤都有发生软骨炎的可能性,突出了即使对于相对轻微的损伤也需要仔细进行伤口处理的必要性。前瞻性识别出将会发生感染的耳部极其困难,再加上更积极的预防方法所带来的风险,使得这些方法并无必要。