Miller D R, Murphy K, Cesario T
J Thorac Cardiovasc Surg. 1978 Nov;76(5):723-8.
Pseudomonas osteochondritis of the chest wall and sternum has rarely been reported, but when present it has been extremely difficult to eradicate. Multiple operations to debride the involved areas and use of antibiotics have often been inadequate to control this resistant infection. This report describes our experience with three patients who had the late development of Pseudomonas osteochondritis of the chest wall. The infection occurred following crush trauma, sternotomy for congenital heart disease, and mastectomy and amputation of the upper extremity for carcinoma of the breast. Antibiotic therapy alone and with limited operations was unsuccessful in controlling the infection in all three instances. Eventually, each patient required extensive regional surgical removal of involved bone and cartilage. Complete healing followed. Our experience favors the early wide removal of bony and cartilaginous tissues in the involved region with preoperative and postoperative coverage by appropriate antibiotics. Operative management is detailed.
胸壁和胸骨的假单胞菌性骨软骨炎鲜有报道，但一旦出现，极难根除。多次清创受累区域的手术以及使用抗生素往往不足以控制这种耐药感染。本报告描述了我们对三名胸壁假单胞菌性骨软骨炎晚期患者的治疗经验。感染分别发生在挤压伤、先天性心脏病胸骨切开术后、乳腺癌乳房切除术及上肢截肢术后。在这三例中，仅用抗生素治疗以及有限的手术均未能成功控制感染。最终，每位患者都需要广泛地局部手术切除受累的骨骼和软骨。随后实现了完全愈合。我们的经验表明，应早期广泛切除受累区域的骨和软骨组织，并在术前和术后使用适当的抗生素。文中详述了手术治疗方法。
