感染组织扩展器的管理
Jonas A Nelson1, Perri S Vingan1, Francis D Graziano1
1Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Plastic and reconstructive surgery
|October 25, 2024
概括
乳房重建后的组织扩展器感染是常见的. 及时的抗生素和手术提高了救援率,而植入物替代提供了最好的结果.
科学领域:
- 整形外科 整形外科 整形外科
- 乳房重建 乳房重建
- 手术并发症 手术并发症
背景情况:
- 组织扩展器感染是基于植入物的两阶段乳房重建的重要并发症.
- 识别风险因素和挽救率对于改善患者的治疗结果至关重要.
研究的目的:
- 评估组织扩张器感染和重建性损失的风险因素.
- 为了检查感染后的重建性救援率.
主要方法:
- 对305名患有组织扩展器感染的患者进行了回顾性审查,这些患者接受了基于植入物的两阶段乳房重建 (2017-2022年).
- 分析包括用抗生素治疗的患者,干预性放射性排水和/或手术管理.
- 重建成功被定义为组织扩展器放置后1年的重建维护.
主要成果:
- 较高的BMI,高血压,辐射,双边扩展器,非细胞皮肤基质,乳房切除重量增加和节省乳头的乳房切除与更高的感染风险有关.
- 患有组织扩展器感染的患者1年重建性失败率为54%.
- 黑人种族和格拉姆阴性培养增加了重建性失败的危险;植入物替换显示出最好的成功率.
结论:
- 总体而言,46%的围围假体感染患者成功挽救.
- 建议对组织扩展器感染进行静脉注射抗生素和早期手术干预.
- 实践正在从干预性放射性排水转向围围假体感染的最终手术管理.
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