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首页> 外文期刊>Medecine et maladies infectieuses >Stump infections after major lower-limb amputation: A 10-year retrospective study
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Stump infections after major lower-limb amputation: A 10-year retrospective study

机译：下肢大截肢后的残端感染：一项为期10年的回顾性研究

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摘要

Background and purpose: There is little published data on the diagnostic and therapeutic management of lower-limb stump infections (excluding toe and forefoot amputations). Patients and methods: We made a retrospective observational study of 72 patients having undergone a major lower-limb amputation for a vascular or traumatic reason, complicated by post-surgical stump infection, between January 1, 2000 and December 31, 2009. Results: Stump infection was diagnosed more than 6. weeks after amputation in half of the patients. Staphylococcus was the most frequently isolated bacterium. Ultrasonography and CT scan combined with fistulography were useful to confirm the diagnosis and to determine the extension of infection. Thirty-two patients (44%) needed surgical revision in addition to antibiotic treatment. Patients diagnosed with bone infection more frequently required complementary surgery than those with soft tissue infection (P<. 0.001). Conclusion: The optimal management of this type of infection requires obtaining reliable bacteriological documentation (abscess aspiration in case of soft tissue infection or bone biopsy in case of osteomyelitis) to adapt to the antibiotic treatment. The management should be multidisciplinary (orthopedic or vascular surgeons, rehabilitation specialists, and infectious diseases physicians). Most patients may use prosthesis once the infection is treated.
机译：背景和目的：关于下肢残端感染（不包括脚趾和前脚截肢）的诊断和治疗管理的公开数据很少。患者和方法：我们对2000年1月1日至2009年12月之间因血管或外伤原因并发手术后残端感染并发大面积下肢截肢的72例患者进行了一项回顾性观察性研究。一半的患者在截肢后六周以上被诊断出感染。葡萄球菌是最常分离的细菌。超声检查和CT扫描结合瘘管造影有助于确定诊断和确定感染范围。除抗生素治疗外，三十二名患者（44％）还需要进行外科手术翻修。与患有软组织感染的患者相比，被诊断出患有骨感染的患者更需要辅助手术（P <0.001）。结论：要对这种类型的感染进行最佳处理，需要获得可靠的细菌学证据（如发生软组织感染则需进行误吸或如因骨髓炎需进行骨活检）以适应抗生素治疗。管理应该是多学科的（骨科或血管外科医师，康复专家和传染病医师）。一旦感染得到治疗，大多数患者可以使用假体。

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