深部胸骨切口感染预防及治疗的研究进展

Recent advances on prevention and management of deep sternal wound infection

深部胸骨切口感染(DSWI)是正中胸骨切开术后罕见但严重的一种并发症。DSWI的治疗周期长,预后不理想,对患者的生活质量和心理健康造成了一定影响。该现状的改善需要临床医师的多学科合作,医师术前及时识别危险因素,并采取有效的预防措施,术后一旦发现切口感染及时处理,可避免感染进展到胸骨及纵膈。在明确DSWI的情况下,整形外科医师选择适合患者的治疗方案,及时控制感染实现胸骨重建。目前,DSWI的预防尚未引起足够的重视,治疗多依赖于医师自身的经历与理解,缺乏共识。该文对DSWI的预防和治疗的相关进展作一综述。

Deep sternal wound infection(DSWI)is a rare but seriously damaging complication after median sternotomy.The quality of life and psychological health of patients may be affected due to long management period and unsatisfactory prognosis of DSWI.The improvement of this situation requires multidisciplinary cooperation.Cardiac surgeons should identify risk factors in a timely manner before surgery,take effective preventive measures,and treat incisional infections when detected after surgery to avoid the progression of infection to the sternum and mediastinum.With a definite diagnosis of DSWI,plastic surgeons are required to choose appropriate management protocols to control the infection and achieve sternal reconstruction in a timely manner.At present,prevention of DSWI has not received sufficient attention.DSWI treatment is mostly dependent on doctors’own experience and understanding,and consensus is lacking.This article provide a review of the progress in the prevention and treatment of DSWI.