Infiltrating Wound Vacuum-Assisted Closure With Topical Amphotericin for Mucormycosis Infection of the Achilles Tendon.

Marco A Romo, Garrison Leach, Christopher M Reid, Riley A Dean, Ahmed Suliman
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Abstract

Background: The rarity and heterogeneity of mucormycosis make treatment variable, and no prospective or randomized clinical trials exist in plastic surgery literature. The use of wound vacuum-assisted closure in combination with the instillation of amphotericin B to treat cutaneous mucormycosis is not well documented.

Case presentation: A 53-year-old man underwent left Achilles tendon reconstruction with allograft after a complete tear during exercise. About 1 week after the operation, he began having incisional breakdown later found to be secondary to mucormycosis infection, prompting presentation to an emergency department. The use of negative pressure wound therapy with wound vacuum-assisted closure and intervals of instilling amphotericin B facilitated infection control in this lower extremity mucormycosis infection.

Conclusions: Patients with a localized mucormycosis infection may benefit from treatment with an instillation wound vacuum-assisted closure with topical amphotericin B as presented in this case study.

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浸润性伤口真空辅助封闭局部两性霉素治疗跟腱毛霉菌感染。
背景:毛霉病的罕见性和异质性使得治疗方法多变,在整形外科文献中没有前瞻性或随机临床试验。使用伤口真空辅助封闭结合两性霉素B的灌注治疗皮肤毛霉病没有很好的文献记录。病例介绍:一名53岁男性在运动中完全撕裂后接受左跟腱异体移植重建。手术后约1周,患者开始出现切口破裂,后来发现是继发于毛霉菌感染,并被送往急诊科。负压创面治疗,伤口真空辅助封闭和间隔时间滴注两性霉素B有助于控制下肢毛霉菌感染。结论:在本病例研究中,局部毛霉感染的患者可能受益于伤口真空辅助封闭滴注两性霉素B的治疗。
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