Lanckohr Christian, Horn Dagmar, Roßlenbroich Steffen, Raschke Michael J, Hirsch Tobias, Stolberg-Stolberg Josef
Antibiotic Stewardship (ABS)-Team, Institut für Hygiene, Universitätsklinikum Münster, Robert-Koch-Straße 41, 48149, Münster, Deutschland.
Geschäftsbereich Apotheke, Universitätsklinikum Münster, Münster, Deutschland.
Anaesthesiologie. 2024 Sep;73(9):608-616. doi: 10.1007/s00101-024-01442-0. Epub 2024 Aug 12.
Necrotizing soft tissue infections are a heterogeneous group of severe infections of the skin, connective tissue and muscles in which necrotic destruction of the tissue occurs at the site of infection. Various bacteria are known as "typical" triggering pathogens and the infection can occur on the entire surface of the body. Necrotizing soft tissue infections are always a time-sensitive emergency associated with high mortality. Many affected patients are critically ill and require treatment in an intensive care unit. The rapid and radical surgical treatment is an essential part of management and in addition an adequate and timely antimicrobial treatment is of great importance. The health consequences for surviving patients are often severe, as extensive soft tissue damage leads to functional impairments. In many cases extensive plastic surgery follow-up is necessary. Therefore, necrotizing soft tissue infections are "complicated" in every phase of the disease and require interprofessional treatment. This review article provides a current overview of various aspects of the diagnostics, treatment and aftercare of necrotizing soft tissue infections.
坏死性软组织感染是一组异质性的严重感染性疾病,累及皮肤、结缔组织和肌肉,感染部位会出现组织坏死性破坏。多种细菌被认为是“典型”的触发病原体,且感染可发生于全身各处。坏死性软组织感染始终是一种时间紧迫的急症,死亡率很高。许多受影响的患者病情危重,需要在重症监护病房接受治疗。迅速而彻底的手术治疗是治疗的重要组成部分,此外,充分及时的抗菌治疗也至关重要。幸存患者的健康后果往往很严重,因为广泛的软组织损伤会导致功能障碍。在许多情况下,需要进行广泛的整形手术后续治疗。因此,坏死性软组织感染在疾病的每个阶段都是“复杂的”,需要多专业协作治疗。这篇综述文章提供了关于坏死性软组织感染诊断、治疗及后续护理各方面的最新概述。