期刊文献+

负压封闭引流术在治疗脊柱术后早期深部感染中的应用 被引量:3

Vacuum Sealing Drainage for Early Deep Infection after Posterior Spinal Internal Fixation
原文传递
导出
摘要 目的探讨负压封闭引流术治疗脊柱后路内固定术后早期深部感染的临床疗效。方法回顾性分析2009年3月-2012年3月采用负压封闭引流术治疗脊柱后路内固定术后早期深部感染患者9例,其中男5例,女4例;年龄21~64岁,平均44.6岁。所有患者均行手术清创,保留原有内固定,并采用负压封闭引流的治疗方式。结果患者经负压封闭引流术治疗1~3次,平均2.1次,每次3~7d;所有患者接受6~38个月的随访,平均18个月,伤口均愈合,无腰痛、切口疼痛、红肿、渗出及窦道形成等;再次行影像学检查未见骨质破坏;复查血沉、C反应蛋白、白细胞总数及分类明显下降或降至正常。结论负压封闭引流术是治疗脊柱后路内固定术后早期深部感染的有效方法。 Objective To analyze the curative effect of vacuum sealing drainage for early deep infection after posterior spinal internal fixation. Methods From March 2009 to March 2012, 9 patients with early deep infection after posterior spinal internal fixation, including 5 males and 4 females aged between 21 and 64 years, averaging at 44.6, underwent debridement and vacuum sealing drainage (VSD). Original fixtures in all the patients were not taken out. Results The patients were treated by VSD for once to three times with an average of 2.1 times, and VSD continued for 3 to 7 days every time. Two patients underwent one time of VSD, 4 underwent twice, and 3 underwent three times. In these patients, 6 achieved wound healing after VSD, one changed to ordinary dressing and wound suturing two weeks later due to hemorrhage of VSD, one changed to ordinary dressing and wound suturing wound three weeks later due to impeded drainage, one accepted skin-grafting after three times of VSD. All the patients were followed up for 6 to 38 months (18 months on average) and all of them were cured. There was no obvious back pain or signs of incision infection. The X-ray films showed that there were no bone destruction and the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein significantly decreased to normal after surgery. Conclusions One-stage debridement and vacuum sealing drainage therapy is an effective method for treating early deep infection after posterior spinal internal fixation.
出处 《华西医学》 CAS 2014年第4期685-687,共3页 West China Medical Journal
关键词 脊柱 内固定 感染 负压 Spinal Internal fixation Infection Vacuum
  • 引文网络
  • 相关文献

参考文献16

  • 1Wimmer C, Gluch H. Management of postoperative wound infection in posterior spinal fusion with instrumentation[J].J Spinal Disord, 1996,9(6): 505-508.
  • 2BeinerJM, GrauerJ, Kwon BK, et al. Postoperative wound infections of the spine[J]. Neurosurg Focus, 2003, 15(3): E14.
  • 3Kim KW, Ha KY, Kim MS, et al. Postoperative trichosporon asahii spondylodiscitis after open lumbar discectomy: a case report[J]. Spine (Phila Pa 1976),2008,33(4): EI16-EI20.
  • 4Kang BU, Lee SH, Ahn Y, et al. Surgical site infection in spinal surgery: detection and management based on serial C-reactive protein measurements[J].J Neurosurg Spine, 2010,13(2): 158-164.
  • 5Nunes BK, Lacerda RA,JardimJM. Systematic review and metaanalysis of the predictive value of C-reactive protein in postoperative infections[J]. Rev Esc Enferm USP, 2011, 45(6): 1488-1494.
  • 6Hong HS, Chang MC, Liu CL, et al. Is aggressive surgery necessary for acute postoperative deep spinal wound infection[J]. Spine (Phila Pa 1976),2008,33(22): 2473-2478.
  • 7Mirovsky Y, Floman Y, Smorgick Y, et al. Management of deep wound infection after posterior lumbar interbody fusion with cages[J].J Spinal Disord Tech, 2007, 20(2): 127-131.
  • 8Soultanis K, Mantelos G, Pagiatakis A, et al. Late infection in patients with scoliosis treated with spinal instrumentation[J]. Clin Orthop Relat Res, 2003(411): 116-123.
  • 9Sierra-Hoffman M,Jinadatha C, CarpenterJL, et al. Postoperative instrumented spine infections: a retrospective review[J]. South MedJ, 2010, 103(1): 25-30.
  • 10Jones GA, ButlerJ, Lieberman I, et al. Negative-pressure wound therapy in the treatment of complex postoperative spinal wound infections: complications and lessons learned using vacuum-assisted closure[J].JNeurosurg Spine, 2007, 6(5): 407-411.

同被引文献22

引证文献3

二级引证文献11

;
使用帮助 返回顶部