Abstract:
Gas-producing infections, such as clostridial and nonclostridial gas gangrene, crepitant cellulitis, and necrotizing fasciitis, are characterized in the literature by a variety of initial presentations, microbial burdens and surgical outcomes-ranging from debridement to amputation to death. The primary aim of this study was to identify the organisms cultured in gas-producing infections of the foot in patients that presented to a large academic medical center over a 10-year period. Our secondary aims were to report the prevalence of sepsis in this population upon presentation, and patient outcomes upon discharge. After a retrospective chart review of 207,534 procedures, 70 surgical cases met inclusion criteria. The most common organisms that grew in operating room cultures were Staphylococcus aureus, Group B Beta Streptococcus, and Enterococcus species. Just over half of the population presented with sepsis. After an average of 2 or more operations, 64% of patients underwent amputation. One death occurred. Gas-producing infections, or \"gas gangrene,\" are primarily polymicrobial infections, rarely due to Clostridium perfringens, that warrant surgical exploration for optimal outcomes.
摘要:
产气感染,如梭菌和非梭菌气体坏疽,Crepitant蜂窝织炎,坏死性筋膜炎,在文献中的特点是各种初始陈述,微生物负担和手术结果-从清创到截肢到死亡。这项研究的主要目的是确定在10年内向大型学术医疗中心就诊的患者中,足部产气感染中培养的生物。我们的次要目的是报告该人群中败血症的患病率,和患者出院后的结果。在对207,534个程序进行回顾性图表审查后,70例手术病例符合纳入标准。在手术室培养中生长的最常见的生物是金黄色葡萄球菌,B组β链球菌,和肠球菌。超过一半的人口出现败血症。在平均2次或更多次操作后,64%的患者行截肢。发生了一次死亡。产气感染,或“气体坏疽,“主要是多微生物感染,很少是由于产气荚膜梭菌,这需要手术探索以获得最佳结果。