Thornton F J, Schäffer M R, Barbul A
Department of Surgery, Sinai Hospital of Baltimore, Maryland 21215, USA.
Shock. 1997 Dec;8(6):391-401.
Wound healing represents a dynamic and immediate response of the body to tissue injury with the purpose of restoring anatomical continuity, structure and function. Success or failure of this complex cascade of events is determined largely by competence of the host's immune system. Sepsis represents one of the most formidable threats to successful wound healing. It can present as a local bacterial colonization of the injury site with minimal systemic reaction or the "systemic inflammatory response syndrome," a primary cause of mortality among critically ill patients. Trauma also predisposes patients to wound complications especially as a result of post-traumatic immunosuppression. This phenomenon exposes the patient to the risk of microbial infection and ultimately the sepsis syndrome. The immune system, therefore, represents a vulnerable gateway through which trauma and sepsis exert their deleterious effect on the wound healing process resulting in increased morbidity and mortality for the surgical patient.
伤口愈合是身体对组织损伤的一种动态且即时的反应,目的是恢复解剖学上的连续性、结构和功能。这一系列复杂事件的成败很大程度上取决于宿主免疫系统的能力。脓毒症是成功伤口愈合面临的最严峻威胁之一。它可表现为损伤部位的局部细菌定植,全身反应极小,也可表现为“全身炎症反应综合征”,这是重症患者死亡的主要原因。创伤还使患者易发生伤口并发症,尤其是创伤后免疫抑制的结果。这种现象使患者面临微生物感染的风险,最终导致脓毒症综合征。因此,免疫系统是一个脆弱的通道,创伤和脓毒症通过它对伤口愈合过程产生有害影响,导致外科患者的发病率和死亡率增加。