摘要
胸骨切开术是心脏、肺脏及纵隔手术中常规的手术路径,而胸骨切开术后裂开是胸骨切开术的常见并发症,其中胸骨切开术后裂开感染是胸心外科常见的术后严重并发症之一。以往胸骨切开术后裂开多采用常规换药、负压伤口疗法、皮肤牵张器等治疗,但这些方法单独应用疗效欠佳,给患者及其家庭造成巨大的痛苦和负担。近几年,采用具有丰富血供的组织瓣修复胸骨切开术后裂开因创面覆盖良好、胸廓重建稳固、感染复发率低及术后并发症少等优势备受关注。本综述回顾了胸骨切开术后裂开的流行病学特点,并且总结了胸骨切开术后裂开的各种分类方法、不同组织瓣修复术的治疗效果。希望通过本综述,为进一步构建胸骨切开术后裂开治疗体系、形成具体救治指南提供依据。
Sternotomy is a routine surgical pathway for heart,lung,and mediastinal surgery.Poststernotomy dehiscence is a common complication of sternotomy,in which infection after poststernotomy dehiscence is one of the most serious postoperative complications in cardiothoracic surgery.Previously,conventional dressing,negative pressure wound therapy,and skin stretching device were used in the treatment of poststernotomy dehiscence,but the outcome of each single method was poor,which caused great pain and burden to the patients and their families.In recent years,tissue flap containing rich blood supply has drawn a lot of attention because of its good wound cover,stable thoracic reconstruction,low infection recurrence rate,and less postoperative complication.In this paper,we reviewed the epidemiological characteristics of poststernotomy dehiscence,and summarized the various classifications for poststernotomy dehiscence and the therapeutic effects of different tissue flap repair.We hope that this review would provide a basis for further construction of the treatment system for poststernotomy dehiscence and the formation of a treatment guideline.
作者
张熠杰
陈刚
官浩
胡大海
Zhang Yijie;Chen Gang;Guan Hao;Hu Dahai(Department of Burns and Cutaneous Surgery,Burn Centre of PLA,the First Affiliated Hospital,Air Force Medical University Xi'an 710032,China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2019年第12期879-883,共5页
Chinese Journal of Burns
基金
国家自然科学基金(81741105)。
