中国组织工程研究2024，Vol.28Issue(17)：2637-2641,5.DOI:10.12307/2024.441
载抗生素骨水泥治疗糖尿病足坏死性筋膜炎致小腿筋膜室综合征
Antibiotic-loaded bone cement in treatment of calf compartment syndrome caused by diabetic foot necrotizing fasciitis
摘要
Abstract
BACKGROUND:At present,the treatment methods for necrotizing fasciitis mostly use negative pressure sealing suction after thorough debridement.This method requires repeated debridement to completely remove necrotic infected tissue,causing serious physical and economic burdens to patients. OBJECTIVE:To introduce a rare clinical case of calf compartment syndrome caused by diabetic foot necrotizing fasciitis,and summarize the clinical experience of using antibiotic-loaded bone cement for treatment and comprehensive management. METHODS:A total of 6 patients with calf compartment syndrome caused by diabetic necrotizing fasciitis admitted to Wuxi 9th Affiliated Hospital of Soochow University from August 2017 to August 2020 were selected,including 5 males and 1 female with an average age of 54 years.During the perioperative period,the patients'general condition was evaluated and systemic nutritional support treatment was given.In the first stage,all patients received complete debridement to control infection,antibiotic-loaded bone cement packing,and negative pressure sealed drainage.In the second stage,bone cement was removed and wound repair was performed.The wound healing,as well as the occurrence of redness,swelling,and exudation was observed during the follow-up. RESULTS AND CONCLUSION:(1)The wounds of four patients were fresh after twice antibiotic-loaded bone cement packing,and the membrane formation was good,and one patient was good after three times of antibiotic-loaded bone cement packing,and the wounds of all five patients healed well after the second stage of skin grafting.Due to the difficulty in maintaining intraoperative blood pressure and infection in all four compartments of the lower leg,a patient underwent emergency knee amputation.Meanwhile,the stump wound was placed with antibiotic-loaded bone cement.The wound was closed directly after the secondary bone cement was removed,and the wound healed in the first stage.(2)The six patients were followed up for 6-24 months after discharge.At the last follow-up,all six patients had good wound healing and no symptoms such as redness,swelling,and exudation.The quality of life of the patients was significantly improved,and all of them were satisfied with the curative effect.(3)The occurrence of calf compartment syndrome should be vigilant when diabetic foot necrotizing fasciitis is highly suspected.Early diagnosis and timely incision decompression are of great importance.Besides,the application of antibiotic-loaded bone cement in the treatment of calf compartment syndrome caused by diabetic necrotizing fasciitis has a good short-term effect.关键词
载抗生素骨水泥/糖尿病/坏死性筋膜炎/筋膜室综合征/保肢Key words
antibiotic-loaded bone cement/diabetes mellitus/necrotizing fasciitis/compartment syndrome/limb salvage分类
医药卫生引用本文复制引用
徐鹏,薛明宇,芮永军,卜凡玉,郭晓峰,谢艺恺..载抗生素骨水泥治疗糖尿病足坏死性筋膜炎致小腿筋膜室综合征[J].中国组织工程研究,2024,28(17):2637-2641,5.基金项目
无锡市卫生健康委科技成果与适宜技术推广项目(T2021022),项目负责人:卜凡玉 Wuxi Municipal Health Commission Science and Technology Achievements and Suitable Technology Promotion Project,No.T2021022(to BFY) （T2021022）
