Pallua N, Machens H G, Becker M, Berger A
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:1144-8.
Sepsis is the commonest cause of death following burn injuries. The main source of the bacteria which cause the onset of sepsis is the burn wound itself. We evaluated the question of whether immediate necrectomy versus early necrectomy leads to a decrease in septic complications, as well as posttraumatic lethality. We evaluated 66 patients, 33 of whom underwent immediate necrectomy (i.e., within the first 3 days posttraumatically, group 1); the remaining 33 patients underwent necrectomy in the early posttraumatic phase (from the fourth posttraumatic day, group 2). Following immediate necrectomy (group 1), septic complications developed in 12.1%, as compared to 33.3% in group 2 (p < 0.01). Lathality was significantly reduced in group 1 with 9.1% compared to 21.2% in group 2 (p < 0.01). In this study it was demonstrated that immediate necrectomy versus early necrectomy in young patients leads to a significant decrease of septic complications and lethality following burn injury.
脓毒症是烧伤后最常见的死亡原因。导致脓毒症发作的细菌的主要来源是烧伤创面本身。我们评估了即刻切除坏死组织与早期切除坏死组织相比是否会降低脓毒症并发症以及创伤后死亡率的问题。我们评估了66例患者,其中33例接受了即刻切除坏死组织(即创伤后3天内,第1组);其余33例患者在创伤后早期(创伤后第4天起,第2组)接受了坏死组织切除术。即刻切除坏死组织后(第1组),脓毒症并发症的发生率为12.1%,而第2组为33.3%(p<0.01)。第1组的死亡率显著降低,为9.1%,而第2组为21.2%(p<0.01)。本研究表明,年轻患者即刻切除坏死组织与早期切除坏死组织相比,可显著降低烧伤后的脓毒症并发症和死亡率。