人体组织扩张器非感染性并发症相关细菌学分析研究

Bacteriological analysis of tissue expanders with non-infective complications

目的:探讨人体应用组织扩张器出现非感染性并发症时诱发细菌感染的可能性及其临床意义。方法:将临床连续应用组织扩张术进行创伤治疗的33例患者的53枚人体组织扩张器分为两组:非感染性并发症组(包括:注射壶外置、扩张囊外露、扩张皮肤破溃、血肿、扩张器渗漏)和无并发症组。所有扩张器在第二次手术取出过程中分别留取扩张器包膜囊壁试子标本,并分别进行临床常规细菌学培养,对该培养阴性结果者,再转移于肉汤管内进行增菌培养以提高培养细菌的检出率。如细菌检出结果呈阳性者同时进行常规药敏实验。其结果应用SPSS软件进行Fisher统计学处理。结果:非感染并发症组细菌检出率为45.45%,1例出现临床感染症状(9.09%)。无并发症组细菌检出率为14.29%,无临床感染症状发生。非感染并发症组细菌检出率明显高于无并发症组(P<0.05〉。检出细菌为金黄色葡萄球菌和凝固酶阴性葡萄球菌,对去甲万古霉素、庆大霉素、利福平、环丙沙星、呋喃妥因敏感。结论:人体组织扩张器出现非感染性并发症时能明显增加该扩张器感染的几率。建议临床除有针对性地处理原发并发症外,还应注意预防感染的发生。

Objective To investigate the incidence of the infection complication of tissue expansion induced by non-infective complications.Methods Fifty-three tissue expanders used in 33 surgical patients were divided into non-infective complication group(11 tissue expanders) and non-complication group(42 tissue expanders).The non-infective complications included in out-place of the injective dome,exposure of the expansive sack,expanded skin damage,hematoma,leakage of the expander.After each expander was removed during the second operation,a specimen was taken from the capsule of the expander and cultured by inoculating it onto the culturing medium.Results The rate of positive bacterial growth in the non-infective complication group was significantly higher than in the non-complication group(45.45% vs 14.29%)(P<0.05).Only one infection complication occurred in the non-infective complication group.The examined bacteria were Staphylococcus aureus and coagulate-negative staphylococci,which were sensitive to Gentamicin、vancomycin、ciprofloxacin.Conclusion The non-infective complications of tissue expansion could potentially increase the incidence of the infection complication.Prophylactic management of infection may need when these complications happened.