Miller S D, Moed B R, Chess J L
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689.
Clin Orthop Relat Res. 1993 Aug(293):265-8.
Postoperative infection of elective surgical wounds with Clostridium species has been linked to gastrointestinal tract lesions. A 55-year-old man with a history of peptic ulcer disease was treated by open reduction and internal fixation with autogeneic cancellous bone grafting from an anterior iliac crest donor site for nonunion of the clavicle. A mild serosanguinous drainage from the Penrose drain site at the iliac crest had ceased on postoperative Day 11; the patient complained of pain and a brownish drainage on postoperative Day 15. The infection was documented with cultures positive for Clostridium perfringens. Aggressive emergent surgical and antibiotic therapy resulted in complete clinical recovery. The wound infection did not advance to severe tissue damage and myonecrosis. This case represents the first reported infection of an iliac crest bone graft site with C. perfringens.
择期手术伤口的梭状芽孢杆菌属术后感染与胃肠道病变有关。一名有消化性溃疡病史的55岁男性因锁骨骨不连接受切开复位内固定术,并取自体髂嵴松质骨移植。术后第11天,髂嵴处彭罗斯引流管部位的轻度浆液性引流已停止;患者在术后第15天抱怨疼痛和褐色引流物。培养结果显示产气荚膜梭菌阳性,证实存在感染。积极的紧急手术和抗生素治疗使患者完全康复。伤口感染未发展为严重的组织损伤和肌坏死。该病例是首例报道的产气荚膜梭菌感染髂嵴骨移植部位的病例。