MEBT/MEBO联合扩创引流治愈拇指粪肠球菌感染继发指腹缺损1例

Healing of Thumb Pulp Defect Secondary to Enterococcus Infection Treated with MEBT/MEBO Combined with Expanded and Drainage:A Case Report

患者男,60岁,左手拇指红肿疼痛2周,切开排脓术后1周。患者2周前不慎被牙签扎伤左手拇指指腹,因出现左手拇指红肿、胀痛,至外院行切开排脓术并定期换药,无效。皮肤科情况:左手拇指指腹可见一长约2cm纵向切口,创缘皮肤发白,切口内流出大量灰白色脓液,创内可探及大量黑色坏死组织,伤口微生物培养提示:粪肠球菌感染。诊断:左手拇指化脓性感染合并左手拇指软组织缺损。治疗:经扩创、贯通式引流、湿润烧伤膏(MEBO)填充换药后感染控制,缺损创面原位再生,随访3个月塑形良好。

A 60-year-old male with a 2-week history of left thumb redness,swelling,and pain presented at our hospital 1 week after the incision and drainage surgery.The patient accidentally injured his left thumb pulp with a toothpick 2 weeks ago,resulting in left thumb redness,swelling,and pain.Incision,drainage and dressing changes done at an outside hospital were ineffective.Specialized examination showed a longitudinal incision of about 2 cm was seen on the left thumb pulp,the wound edges were pale,and a large amount of grayish-white pus was draining from the wound.Extensive black necrotic tissue was found in the wound.Microbial culture of the wound suggested Enterococcus faecalis infection.Diagnosis:suppurative infection of the left thumb with left thumb soft tissue defect.Treatment:after wound expansion,through-and-through drainage,and moist exposed burn ointment(MEBO)dressing changes,the infection was controlled,and the wound healed in situ.A follow-up at 3 months showed good condition of the thumb.