冠状动脉搭桥术后胸骨伤口感染的真空封闭治疗

H. Erdem, Ayse Karakoc, Seda Karasakal, Yeliz Karacı, A. Antal, H. Sunar
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引用次数: 1

摘要

导读:据报道,真空辅助封闭胸骨感染伤口不仅可以减少住院时间,还可以提高发病率和死亡率。本研究的目的是评估真空辅助封闭冠状动脉搭桥术后感染胸骨伤口的早期结果。患者与方法:选取2016年1月至2019年12月在我院行冠状动脉搭桥术后发生胸骨伤口感染的患者66例。在手术清创和清除异物后,平均术后26.56±5.5天开始进行真空辅助闭合治疗。在伤口愈合和阴性培养后,终止治疗并按适当程序关闭胸骨伤口。结果:56例(84.84%)胸骨深部感染,10例(15.15%)胸骨浅表感染。早期死亡率为13.63%(9例),均为深部胸骨感染。最常见的微生物培养为金黄色葡萄球菌和铜绿假单胞菌。平均住院时间39.68±2.48 d。未发现与真空辅助闭合相关的并发症。存活患者无复发性胸骨伤口感染。结论:我们的研究结果证实了真空辅助伤口闭合是一种安全有效的治疗选择,对于那些不适合初次闭合或早期肌肉瓣闭合的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vacuum-Assisted Closure for Sternal Wound Infection After Coronary Artery Bypass Surgery
Introduction: Vacuum-assisted closure of sternal infected wounds has been reported to improve morbidity and mortality, besides decreasing duration of hospitalization. The aim of this study was to evaluate early outcomes of vacuum-assisted closure of infected sternal wounds after coronary bypass surgery in our clinic. Patients and Methods: Sixty six patients who had sternal wound infection after coronary bypass surgery in our hospital between January 2016 and December 2019 were included in the study. After surgical debridement and removal of foreign materials, vacuum-assisted closure therapy was initiated at a mean postoperative 26.56 ± 5.5 days. After wound healing and negative cultures, treatment was terminated and sternal wounds were closed with appropriate procedures. Results: Fifty six patients (84.84%) had deep sternal infection and 10 patients (15.15%) had superficial sternal infection. Early mortality was 13.63% (nine patients), all having deep sternal infections. The most common microorganisms cultured were Staphylococcus aureus and Pseudomonas aeruginosa. Mean duration of hospitalization was 39.68 ± 2.48 days. No complications related with vacuum-assisted closure were detected. Recurrent sternal wound infection was not observed in any of the surviving patients. Conclusion: Our results confirm that vacuum-assisted closure of wounds is a safe and effective treatment option for patients who are not candidates for primary closure or early muscle flap closure.
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