Wound Infections in Renal Transplant Wounds: Pathogenetic and Prognostic Factors
Wound Infections in Renal Transplant Wounds: Pathogenetic and Prognostic Factors
复制标题
肾移植伤口感染：发病机制和预后因素
作者：
G. Kyriakides;R. Simmons
我们对 27 名患有伤口感染的移植患者进行了研究，对导致移植伤口感染的因素以及决定其结果的因素进行了研究。无关的尸体肾脏、糖尿病、尿瘘和伤口血肿都是伤口感染的易感因素。该系列中伤口感染的总体发生率为 6.1% (27/439)。当排除已知可预防原因（即血肿和瘘管）继发的感染时，伤口感染的发生率仅为 1.6%。此外，如果排除糖尿病患者和再次移植患者，非糖尿病患者首次移植时伤口感染的发生率仅为0.7%。肾周围感染比浅表感染严重得多，预后也更差。伤口感染的总体死亡率为 30% (8/27)，大多数死亡是由深层感染引起的败血症引起的。只有三名患者（11%）治愈了伤口并保住了肾脏，而其余幸存者（15/18）治愈了伤口但失去了肾脏。需要强调的是，预防血肿和尿瘘是预防移植伤口感染最重要的措施。
The factors contributing to transplant wound infection, as well as those determining its outcome, have been reviewed in 27 transplant patients with wound infection. Unrelated cadaver kidneys, diabetes, urinary fistulas and wound hematomas are all factors predisposing to wound infection. Overall incidence of wound infection in this series was 6.1% (27/439). When infections secondary to known preventable causes (i.e. hematomas and fistulas) were excluded, the incidence of wound infection was only 1.6%. Furthermore, if diabetics and retransplanted patients were excluded, the incidence of wound infection in non-diabetic patients who had their first transplant was only 0.7%. Perinephric infections are much more serious and carry a worse prognosis than superficial infections. Overall mortality of wound infections was 30% (8/27), most deaths being caused by sepsis from deep infection. Only three patients (11%) healed their wounds and saved their kidneys, whereas the rest of the survivors (15/18) healed their wounds but lost their kidneys. It is emphasized that prevention of hematomas and urinary fistulas is the most important measure in the prevention of transplant wound infection.