PRS:16 年经验2630例手术经验分享——隆鼻术后感染的发生率和易感因素

2022-09-20 网络 网络

目前,已确定的鼻整形术后感染的危险因素包括吸烟和手术时间大于或等于3小时。术前手术或外伤造成的鼻皮肤血管供应不足也被认为是诱发因素进一步证明糖尿病患者鼻内定植金黄色葡萄球菌的发生率增加,这本身与术后感

目前,已确定的鼻整形术后感染的危险因素包括吸烟和手术时间大于或等于3小时。术前手术或外伤造成的鼻皮肤血管供应不足也被认为是诱发因素进一步证明糖尿病患者鼻内定植金黄色葡萄球菌的发生率增加,这本身与术后感染的发展有关。

基于大规模研究的数据,确定鼻后成形术的感染率和易感因素是很重要的。该研究评估了东亚人群鼻整形术后和鼻翻修术后感染的发生率、手术前因素和临床特征。

图1 文章来源

研究者认为该研究对鼻整形外科医生的临床实践有潜在的帮助:通过量化感染风险,帮助患者同意;通过确定常见感染部位和感染时间,对患者和工作人员进行教育,并促进早期发现;并根据超过16年的经验,识别高危病例并提供预防和治疗策略。

该研究回顾性分析了2003年7月至2018年6月东亚地区由单一医师(Y.J.J.)完成的2630例鼻整形手术。男性患者为1595名(69.9%),女性患者为687名(30.1%),平均年龄为31岁。比较初诊病例与复诊病例的感染发生率,并根据所用材料进行分析。

该研究评价了培养的微生物、感染发展和干预时间等术后处理。结果:2134例原发病例,496例修订病例。材料包括自体肋软骨(413例)、耳甲软骨(572例)、同筋膜阔筋膜(829例)、同源肋软骨(102例)、Gore-Tex(373例)、硅胶(32例)。

图2 鼻尖移植物感染。鼻尖是最常见的感染部位。49岁男性使用自体肋软骨,术后14周(左)和术后2周使用抗生素治疗和手术修复(右)

该研究确定了22例(0.84%)术后感染,其中18例是需要翻修。鼻修复手术的感染率比原发手术高19倍(3.63%比0.19%)。

女性感染的可能性是女性的3.6倍(p = 0.002)。使用自体肋软骨的感染率为3.39%,同时矫正鼻中隔穿孔的感染率为8.57%。11例(50%)在术后1个月内(12±7天)发生感染。8例培养耐甲氧西林金黄色葡萄球菌。

感染表现在鼻尖的占45%,鼻中隔/鼻小柱尾端的占32%。20例(90.9%)接受手术干预。

综上所述,女性鼻修复手术需要使用肋软骨或同时矫正鼻中隔穿孔,术后感染的风险较高,通常表现为鼻尖和鼻中隔/小柱尾区红斑和肿胀,常需要手术治疗。

 

原始文章:

Tran Khanh Ngoc,Jang Yong Ju,Incidence and Predisposing Factors of Postoperative Infection after Rhinoplasty: A Single Surgeon's 16-Year Experience with 2630 Cases in an East Asian Population.[J] .Plast Reconstr Surg, 2022, 150: 51e-59e.

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    2022-09-06 kzlchina
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    2022-09-20 远离**踢

    "女性感染的可能性是女性的3.6倍(p = 0.002)。"是病句把。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1669099, encodeId=98b816690995a, content=<a href='/topic/show?id=bc2114e79b8' target=_blank style='color:#2F92EE;'>#PRS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14779, encryptionId=bc2114e79b8, topicName=PRS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=209526497271, createdName=kzlchina, createdTime=Tue Sep 06 19:32:43 CST 2022, time=2022-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716892, encodeId=91001e16892d3, content=<a href='/topic/show?id=078ee851084' target=_blank style='color:#2F92EE;'>#经验分享#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78510, encryptionId=078ee851084, topicName=经验分享)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96a132348876, createdName=rebeccajiejie, createdTime=Fri Mar 31 06:32:43 CST 2023, time=2023-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826823, encodeId=4c8318268230b, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Sat Dec 03 04:32:43 CST 2022, time=2022-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2089332, encodeId=e453208933205, content="女性感染的可能性是女性的3.6倍(p = 0.002)。"是病句把。, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=fafd5636693, createdName=远离**踢, createdTime=Tue Sep 20 13:35:25 CST 2022, time=2022-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2089269, encodeId=44f72089269bf, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Sep 20 09:42:03 CST 2022, time=2022-09-20, status=1, ipAttribution=)]
    2022-09-20 yangchou

    好文章,谢谢分享。

    0

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