中华损伤与修复杂志(电子版)2024,Vol.19Issue(6) :498-502.DOI:10.3877/cma.j.issn.1673-9450.2024.06.008

采用抗生素骨水泥治疗糖尿病患者心脏术后胸骨骨髓炎的临床效果观察

Clinical effect of antibiotic bone cement in the treatment of sternal osteomyelitis after cardiac surgery for patients with diabetes mellitus

徐志刚 曹涛 何亭 李博奥 魏婧韬 张栋梁 官浩 杨薛康
中华损伤与修复杂志(电子版)2024,Vol.19Issue(6) :498-502.DOI:10.3877/cma.j.issn.1673-9450.2024.06.008

采用抗生素骨水泥治疗糖尿病患者心脏术后胸骨骨髓炎的临床效果观察

Clinical effect of antibiotic bone cement in the treatment of sternal osteomyelitis after cardiac surgery for patients with diabetes mellitus

徐志刚 1曹涛 1何亭 1李博奥 1魏婧韬 1张栋梁 1官浩 1杨薛康1
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作者信息

  • 1. 710032 西安,空军军医大学第一附属医院全军烧伤中心 烧伤与皮肤外科
  • 折叠

摘要

目的 探讨采用抗生素骨水泥治疗糖尿病患者心脏术后胸骨骨髓炎的临床效果.方法 2019年3月至2023年2月,空军军医大学第一附属医院烧伤与皮肤外科收治符合纳入与排除标准的心脏外科开胸术后发生胸骨骨髓炎的糖尿病患者23例,对其临床资料进行回顾性分析.患者入院后首先行创面分泌物细菌培养,一期术中彻底清创后填充抗生素骨水泥,2~4周后待创面无明显渗出,再次手术取出骨水泥,沿深筋膜层充分游离伤口两侧软组织形成皮肤筋膜瓣,两侧皮肤筋膜瓣直接拉拢缝合修复.结果 23例患者中21例创面一期愈合,随访半年无复发;1例拆线后伤口裂开约1 cm,门诊换药7 d后愈合;1例出院1个月后伤口再次破溃形成窦道,再次入院按此方法治疗后痊愈.结论 抗生素骨水泥是治疗糖尿病患者心脏术后胸骨骨髓炎的有效方法.

Abstract

Objective To investigate the clinical effect of antibiotic bone cement in the treatment of sternal osteomyelitis after cardiac surgery for patients with diabetes mellitus. Methods The clinical data of 23 diabetes mellitus patients with sternal osteomyelitis after cardiac surgery admitted to the Department of Burn and Skin Surgery,the First Affiliated Hospital of Air Force Medical University from March 2019 to February 2023 were retrospectively analyzed. All patients underwent bacterial culture of wound secretions. The antibiotic bone cement was filled after thorough debridement in one-stage operation. After 2 to 4 weeks,when there was no obvious exudation from the wound surface,the bone cement was taken out again,and the soft tissue on both sides of the wound was fully freed along the deep fascia layer to form a skin fascia flap,and the skin fascia flap on both sides were directly sutured. Results Among the 23 patients,the wound of 21 patients healed by first intention and no recurrence was found after a six-month follow-up. The wound of one patient dehisced about 1 cm after taking out the sutures,and healed after 7 days of dressing change. The wound of one patient ruptured again and formed sinus one month after discharge,and recovered after readmission. Conclusion The use of antibiotic bone cement is an effective method to treat sternalosteomyelitis after cardiac surgery in patients with diabetes mellitus.

关键词

胸骨骨髓炎/糖尿病/骨水泥/抗生素/创面修复

Key words

Sternal osteomyelitis/Diabetes mellitus/Bone cement/Antibiotics/Wound repair

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出版年

2024
中华损伤与修复杂志(电子版)
中华医学会

中华损伤与修复杂志(电子版)

CSTPCD
影响因子:0.936
ISSN:1673-9450
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