评估第二次脱皮的时间和死亡率在死结软组织感染中
Henry L Kircher1, Jacob C O'Dell2, Lynn Chollet-Hinton3
1University of Kansas School of Medicine, Kansas, KS, USA.
The American surgeon
|October 25, 2023
概括
死软组织感染患者通常需要多次手术. 这项研究发现,第二次除血在24小时内或之后的死亡率没有差异,尽管指南建议更早介入.
科学领域:
- 手术感染 手术感染
- 传染性疾病 传染性疾病
- 创伤外科 手术 创伤外科
背景情况:
- 末性软组织感染 (NSTI) 经常需要多次手术除.
- 目前的指导方针建议在首次手术后24小时内进行第二次脱bridement,但证据有限.
- 第二次脱bridement的延迟可能与死亡率的增加有关.
研究的目的:
- 评估第二次脱bridement的时间对NSTI患者住院死亡率的影响.
- 为了评估第二次除bridement的推24小时间隔的遵守.
主要方法:
- 77名NSTI患者的回顾性队列研究 (01/01/0809/01/21).
- 根据接受第二次脱bridement <24小时或≥24小时后初始脱bridement,患者被分组.
- 主要结局是住院死亡率;次要结局包括ICU停留时间和伤口关闭.
主要成果:
- 第二次除bridement的中位时间为40小时.
- 只有15.6%的患者在24小时内接受了第二次除bridement.
- 在<24小时组 (25.0%) 和≥24小时组 (6.2%;P = .07) 之间没有观察到在医院死亡率的显著差异.
结论:
- 第二次脱bridement在24小时内或之后的时间对该队列的住院死亡率没有影响.
- 对第二次除菌的24小时建议的遵守率很低.
- 需要进一步的研究来确定NSTI中第二次脱bridement的最佳时间.
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