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负压伤口疗法治疗指尖长期感染性气性坏疽

Negative Pressure Wound Therapy for Gas Gangrene of the Fingertip with Prolonged Infection.

作者信息

Okamoto Yasufumi, Maeda Kazuhiro, Yukawa Mitsuhito, Nishimura Reiji, Nagamine Yuji, Hadano Yuka, Mandai Ayano, Udaka Jun, Miyawaki Takeshi, Saito Mitsuru

机构信息

From the Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Hand Surgery Center, The Jikei University Hospital, Tokyo, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2024 May 1;12(5):e5782. doi: 10.1097/GOX.0000000000005782. eCollection 2024 May.

Abstract

BACKGROUND

We encountered a case of infected soft tissue defect of the fingertip treated using negative pressure wound therapy (NPWT). The development of NPWT was started in the early 1990s, and it is a relatively new treatment method included in insurance coverage in Japan in 2010. NPWT is used for intractable wounds; some reports have examined its use on infected wounds. However, to the best of our knowledge, no study has examined its use on infected fingertip wounds.

METHODS

A patient with an infected soft tissue defect in the fingertip whose epithelialization period was prolonged despite continued antibiotic therapy was treated using NPWT in combination.

RESULTS

After NPWT was started, signs of infection and wound granulation were good. Additionally, completion of epithelialization was confirmed 7 weeks after NPWT started.

CONCLUSIONS

Conventionally, skin flap or graft by hand surgeons have been performed on fingertip soft tissue defects with infection. NPWT does not require specialized and advanced surgical techniques; treatment for infected soft tissue defects can be administered by anyone if they have the required skills. In conclusion, NPWT may be considered a suitable alternative when treatment options such as flaps and skin grafts are not feasible.

摘要

背景

我们遇到一例采用负压伤口治疗(NPWT)的指尖感染性软组织缺损病例。NPWT始于20世纪90年代初,是2010年被纳入日本医保覆盖范围的一种相对较新的治疗方法。NPWT用于治疗难治性伤口;一些报告研究了其在感染伤口上的应用。然而,据我们所知,尚无研究探讨其在感染性指尖伤口上的应用。

方法

一名指尖感染性软组织缺损患者,尽管持续使用抗生素治疗,但上皮化期仍延长,采用NPWT联合治疗。

结果

开始NPWT治疗后,感染和伤口肉芽形成的迹象良好。此外,在NPWT开始7周后确认上皮化完成。

结论

传统上,对于伴有感染的指尖软组织缺损,手外科医生会进行皮瓣或植皮手术。NPWT不需要专门和先进的手术技术;如果具备所需技能,任何人都可以对感染性软组织缺损进行治疗。总之,当皮瓣和植皮等治疗选择不可行时,NPWT可被视为一种合适的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33ef/11062726/cedd84a98596/gox-12-e5782-g001.jpg

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