重视胸骨切开术后胸骨深部伤口感染的预防和处理  

Pay attention to the prevention and treatment of deep sternal wound infection after sternotomy

作　　者：官浩 陈阳 Guan Hao;Chen Yang(Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院全军烧伤中心,烧伤与皮肤外科,西安710032

出　　处：《中华烧伤与创面修复杂志》2024年第2期125-130,共6页Chinese Journal of Burns And Wounds

基　　金：教育部中国高校产学研创新基金(2021JH030)。

摘　　要：胸骨深部伤口感染(DSWI)是心脏手术后潜在且灾难性的并发症之一。尽管临床上采用了更小的切口、常规预防性使用抗生素和优化血糖管理等措施,但DSWI的发病率依然在1%~5%波动。DSWI在发生初期的症状和体征均不明显,致使临床医师的干预介入偏晚。DSWI一旦未被及时处理,患者病死率极高。因此,及早预防、诊断和适当处理对于防止DSWI进一步发展至致命的结局非常重要。鉴于DSWI的临床危害性和治疗的复杂性,故本文重点探讨和分享在各个环节中预防DSWI发生的经验、发生后的重建修复策略,以引起广大同行对DSWI的重视。Deep sternal wound infection(DSWI)is one of the potential and catastrophic complications after cardiac surgery.Despite the use of smaller incisions,routine application of prophylactic antibiotic and optimized blood glucose management,the incidence rate of DSWI still fluctuates between 1%and 5%.The early symptoms and signs of DSWI are not often obvious,making it too late for the clinicians to intervene in the process.Once left untreated,DSWI carries a very high mortality rate.Therefore,early prevention,diagnosis,and appropriate management of DSWI are crucial in preventing its progression to life-threatening outcomes.Considering the clinical severity and treatment complexity of DSWI,this article focuses on preventive experiences in each stage of DSWI,and reconstructive strategies after DSWI happens,raising attention among the medical community regarding DSWI.

关 键 词：胸骨切开术 外科伤口感染 纵隔炎 手术后并发症 胸骨深部伤口感染 预防和治疗 创面修复 

分 类 号：R655[医药卫生—外科学]