犬咬伤创口感染分布及特点的研究

目的探讨各部位犬咬伤创n的感染及临床特点。方法900例65岁以下的犬咬伤致撕裂伤患者,按伤部分为头面颈组、手部组、足部组、上肢组、下肢组和躯干组,分别观察各组的感染率、感染时间、临床表现及并发症情况。结果手部组感染率为26．0％,与足部组（22．0％）无显著差异（P〉0．05）,但两者均显著高于头面颈组、上肢组、下肢组、躯干组（分别为7．3％、10．0％、9．3％、11．3％,均P〈0．05）。手部组的感染时间为（13．7±6．7）h、与足部组[（16．0±7．6）h]无显著性差异（P〉0．05）,但两者均显著短于头面颈组、上肢组、下肢组、躯干组[分别为（23．3±11．4）h、（23．1±8．4）h、（21．9±7．8）h、（20．1±6．8）h,均P〈0．05]。头面颈组、上肢组、下肢组、躯干组各组间在感染率、感染时间上差异均无统计学意义（均P〉0．05）。各部位感染的临床表现主要是局部皮肤发红、水肿、明显触痛及发热;并发症主要是脓肿、淋巴管炎／丹毒、关节炎、腱鞘炎、败血症。结论手、足部位的犬咬伤创口是感染最易发生的部位,也最易发生严重的并发症。     

地震灾区犬咬伤的情况分析

目的了解地震后灾区犬咬伤流行病学特征，为制定干预措施提供科学依据。方法通过对四川省绵竹市九龙镇白玉村的1217户约3340人进行入户走访调查，了解犬咬伤的情况及处理。结果共监测到36例犬咬伤伤员，约占被调查者总数的1％。受伤部位以下肢居多，为30例。咬伤事件大多发生在震后1周内出现的2次雷雨过程中，为19例。伤口未得到及时并且正确的处理者12例，4例至今未能接种狂犬病疫苗。结论地震后山区犬咬伤者数量明显超过平时，部分犬咬伤患者不能得到及时正确的处理，犬未能得到及时的管理或捕杀。震后要加大对犬的管理，被犬咬伤后要及时正确地处理伤口，接种狂犬病疫苗，防止狂犬病的发生。     

犬咬伤植皮患者1例的护理

通过1例犬咬伤植皮病人换药的护理，认为犬咬伤护理是一项精心、细致的对其施行身心护理的过程；对患者进行生理、心理状态的调整和对伤处的观察、药物选用及疗效的观察有机的统一，达到治愈的目的。     

1例儿童大面积严重犬咬伤全麻下综合治疗分析

目的探讨全麻下对儿童大面积严重犬伤进行综合治疗的优势方法对1例6岁大面积严重犬伤患儿进行无痛模式下伤口冲洗、注射狂犬患者免疫球蛋白、清创缝合、注射狂犬病疫苗,术后予以抗炎、消肿,并进行心理干预治疗。结果术后伤口均一期愈合,心理测试良好。结论全麻下无痛原则和术后的心理干预的综合治疗在治疗儿童大面积严重犬伤的临床中值得推广。     

犬咬伤后致银屑病1例

患者男 ,48岁。 1998年 10月被犬咬伤左小腿 ,经当地乡村医生治疗 2周而愈。 2周后 ,原伤口及周围发生瘙痒 ,并出现淡红色斑丘疹 ,日渐增多 ,1月后扩散至躯干、四肢及头皮。检查 :体温正常 ,血ＷＢＣ 12 5× 10 9/Ｌ ,中性 0 78,左侧腹股沟可扪及绿豆大淋巴结 3粒 ,活动 ,质中 ,有压痛。其它系统检查未见异常。皮肤科情况 :左小腿中部可见1 5ｃｍ× 2ｃｍ大不规则伤痕 ,伤痕无红肿及分泌物 ,沿伤痕向四周扩散着密集分布粟粒至蚕豆大斑丘疹 ,基底红 ,上覆银白色鳞屑 ,刮去鳞屑有薄膜现象及点状出血。躯干、四肢对称性 ,散在分布类似皮损 ,…     

可疑蜘蛛咬伤2例

1 临床资料例1.女,20岁.因右侧面部肿胀伴疼痛1 d,于2009年5月19日入我科治疗.1 d前患者夜间睡觉时自觉右眉中部刺痛,未予特殊处理.数小时后发现右侧上眼睑疼痛、伴头痛,无明显发热、恶心、呕吐、乏力等,遂到当地医院就诊,诊断为过敏性皮炎,未予处理.     

蜘蛛咬伤58例临床分析

2003年5月-2007年6月我科收治蜘蛛咬伤患者58例,笔者在诊治过程中取得一些经验,现报告如下.     

丽水市558例毒蛇咬伤流行病学分析

目的 分析浙江省丽水市我院2018—2020年住院的毒蛇咬伤就诊病例基本特征和流行病学特征,为临床诊疗、疾病防控及临床诊疗提供依据参考。方法 采集浙江省丽水市中心医院2018—2020年558例毒蛇咬伤病例临床流行病学资料进行回顾性分析,包括毒蛇种类、患者性别与年龄、咬伤月份及具体时间、部位、局部症状及严重程度等。结果 558例病例中,五步蛇194例（34.77%）,竹叶青108例（19.35%）,烙铁头53例（9.50%）,眼镜蛇67例（12.01%）,银环蛇11例（1.97%）,不详120例（21.51%）。其中男、女性别比为2.47∶1;以农民为主,有433例,占77.60%;伤害高发年龄为51～70岁,占55.56%;受伤部位以四肢为主,重度蛇伤患者110例,其中五步蛇咬伤64例（58.18%）,疾病负担相对更重。伤害时间以夏秋季节为主,占90.5%;经过规范救治后,所有患者中治愈出院500例（占89.60%）,好转出院34例（占6.09%）,致残24例（4.31%）,死亡0例（0）。结论 丽水市毒蛇咬伤高发于夏秋季节,以五步蛇为主,眼镜蛇和竹叶青次之;其中重度蛇伤患者多为五步...     

南海某吹填岛礁红火蚁咬伤110例临床分析

回顾性分析2019年1月至2020年1月南海某吹填岛礁医院的卫生统计报表及接诊官兵门诊记录,南海某吹填岛礁红火蚁咬伤官兵红火蚁咬伤性皮炎共计110例,其中过敏性休克11例、中度过敏71例、轻度过敏28例.叮咬部位:手部41例,腿脚60例,面颈9例.红火蚁咬伤部位多为暴露部位,部分患者出现过敏性休克等严重症状,应开展灭蚁...     

蜱咬伤致多脏器功能衰竭一例

患者，男，58岁。5天前胸部皮肤被蜱咬伤后出现红斑、丘疹、肿胀伴痒，2天前前胸皮损出现边缘肿胀，伴胸闷气短，高热、寒战，恶心伴呕吐及阵发性晕厥急诊入院。D二聚体、血清肌酐、磷酸肌酸激酶明显异常，布尼亚病毒核酸检查阴性。诊断：(1)蜱咬伤；(2)多脏器功能障碍综合征。治疗给予糖皮质激素，创面处理等，20余天后患者好转出院。     

联合手术清创治疗坏疽性脓皮病

目的 为了提高坏疽性脓皮病治疗效果,缩短病程,减少瘢痕形成.方法 在坏疽性脓皮病综合治疗基础上,采取手术清创术清除局部溃疡病灶及坏死组织.结果 手术清创组20d治愈率94.3%,未进行清创术组20d治愈率为65.7%,两组间差异有非常显着性,手术组治愈后不遗留严重的瘢痕,且病程缩短.结论 坏疽性脓皮病局部清创可促进病灶修复,缓解疼痛,缩短病程.     

Management of human and animal bite wounds

Bite wounds, usually by dogs, cats, and human beings, affect one of two Americans during his or her lifetime and 1 to 2 million Americans annually. Despite the relative frequency of bite wounds, there are few prospective studies to define optimal care; consequently, diverse methods are used. In this article I review the incidence, bacteriology, clinical spectrum, complications, and treatment of animal and human bite wounds. The spectrum of pathogenic bacteria that cause bite infections is broader than is generally appreciated and includes both aerobic and anaerobic bacteria. Pasteurella multocida is found in only 20% to 25% of dog bite wounds. In choosing empiric antimicrobial therapy, clinicians must consider the diverse causative bacteria and their characteristic susceptibility patterns. Liberal irrigation and elevation of the injured part are also cornerstones of therapy. Early, aggressive medical and surgical management can minimize, if not prevent, complications.     

Chronic problem wounds of dog limbs

Other dermatoses are capable of affecting the limbs and paws of dogs. One should approach the diagnostic workup of these cases in an organized manner, first obtaining a thorough history and performing a physical examination. A variety of diagnostic tests, including skin scrapings, cytology, fungal cultures, bacterial cultures, hematology, serum biochemical profiles, urinalysis, serology, radiology, histopathology, and direct immunofluorescence testing, may be necessary before a definitive diagnosis is reached. Therapy may be surgical, medical, or a combination of both depending upon the etiologic agent.     

Management of human and animal bite wounds: an overview

Serious infections can result from wounds that are caused by bites from animals and humans. Organisms recovered from bite wounds generally originate from the oral cavity of the biting animal, as well as from the patient's skin flora. Anaerobes have been isolated from animal and human bite wound infections, especially those associated with abscess formation. In addition to local wound infections, common complications, such as lymphangitis, septic arthritis, tenosynovitis, and osteomyelitis, and uncommon complications, such as endocarditis, meningitis, brain abscess, and sepsis, may occur. Wound management includes proper local care and, when needed, antimicrobial therapy.     

蜱叮咬的诊治

本文简要介绍了蜱的形态及生活史,并结合国内外近期文献及我科经验,对解除蜱叮咬的常用方法作以归纳评价,并给出了残余口器的处理意见和预防性给药的方案。     

Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital

Aim

to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time.

Clinical observations of mosquito bite reactions in man: a survey of the relationship between age and bite reaction

To evaluate the mechanism of mosquito bite reaction in man, the reaction to Aedes albopictus was observed in 162 subjects ranging in age between 1 to 68 years old. Bite reactions were found to consist of both an immediate and a delayed reaction. The eruption and time course of the immediate reaction were consistent with type I hypersensitivity. The eruption and time course of the delayed reaction were consistent with cutaneous basophil hypersensitivity. Positive rates of immediate reaction increased from early childhood to adolescence and decreased with age from adulthood. The appearance and intensity of the delayed reaction decreased with age. Mosquito bite reactions in human beings exposed continuously and regularly are known to change from stage 1 to stage 5 (stage 1; no reaction, 2; delayed reaction only, 3; immediate and delayed reaction, 4; immediate reaction only, 5; no reaction). Analysis of the relationship between age and bite reaction in this study indicated that the principle held true even when the exposures were irregular or at random.     

A toolkit for the quantitative evaluation of chronic wounds evolution for early detection of non-healing wounds

BackgroundChronic wounds resulting from a number of conditions do not heal properly and can pose serious health problems. Beyond clinician visual inspection, an objective evaluation of the wound is required to assess wound evolution and the effectiveness of therapies.AimOur objective is to provide a methodology for the analysis of wound area vs. time for the early prediction of non-healing wounds evolution.MethodsWe propose a two-step approach consisting of: i) wound area quantification from planimetries and ii) classification of wound healing through the inference of characteristic parameters. For the first step, we describe a user-friendly software (Woundaries) to automatically calculate the wound area and other geometric parameters from hand-traced planimetries. For the second, we use a procedure for the objective classification of wound time evolution and the early assessment of treatment efficacy. The methodology was tested on simulations and retrospectively applied to data from 85 patients to compare the effect of a biological therapy with respect to general basic therapeutics.ResultsWoundaries provides measurements of wound surface equivalent to a validated device. The two-step methodology allows to determine if a wound is healing with high sensitivity, even with limited amount of data. Therefore, it allows the early assessment of the efficacy of a therapy.ConclusionThe performance of this methodology for the quantification and the objective evaluation of wound area evolution suggest it as a useful toolkit to assist clinicians in the early assessment of the efficacy of treatments, leading to a timely change of therapy.