东亚患者ePTFE鼻整形术的综合围手术期感染管理措施（PSMS-11）：一项大样本、长期回顾性研究

文献信息

中文摘要

背景： 膨体聚四氟乙烯（ePTFE）因其良好的稳定性和生物相容性，在东亚鼻整形术中被广泛应用。然而，术后感染作为影响手术效果和患者满意度的主要并发症之一，备受关注。该人群中基于大样本、长期随访的证据仍然有限。
方法： 对2018年1月至2024年12月在本机构接受ePTFE鼻整形术的1153例连续患者进行了回顾性分析。我们比较了感染组与非感染组的人口统计学特征、手术技术和术后结局，以确定感染的危险因素。基于文献回顾和积累的临床经验，一种围手术期系统管理策略——11个决策节点（PSMS-11）被一致地应用于常规实践。评估了感染特征、管理方法和长期结局。
结果： 术后感染发生于少数患者，长期随访期间总体发生率约为1.6%。值得注意的是，超过一半的感染事件出现在术后六个月之后，包括术后一年以上发生的迟发性病例。修复手术、活动性皮肤炎症、吸烟史和不良术后行为与感染风险增加相关。早期局限性感染可在密切监测下考虑保守治疗，而持续或进展性感染则需要取出假体。
结论： 在这项针对东亚患者的大样本、长期回顾性研究中，ePTFE鼻整形术后观察到持续较低的感染率。这些发现提示，PSMS-11所总结的围手术期管理措施的结构化整合，可能有助于在高容量临床实践中维持低感染率。长期随访和个体化治疗决策仍然至关重要。
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英文摘要

BACKGROUND: Expanded polytetrafluoroethylene (ePTFE) has been widely utilized in east Asian rhinoplasty due to its favorable stability and biocompatibility. However, postoperative infection which is one of the major complications affecting surgical outcomes and patient satisfaction presents receive much concern. Evidence based on large cohorts with long-term follow-up in this population remains limited.
METHODS: A retrospective review of 1153 consecutive patients who underwent ePTFE rhinoplasty at our institution from January 2018 to December 2024 was performed. We compared Demographics, surgical techniques, and postoperative outcomes between infected and non-infected cases to identify risk factors for infection. Based on literature review and accumulated clinical experience, a perioperative systematic management strategy-11 Decision Nodes (PSMS-11) was applied consistently in routine practice. Infection characteristics, management approaches, and long-term outcomes were evaluated.
RESULTS: Postoperative infection occurred in a small proportion of patients, with an overall incidence of approximately 1.6% during long-term follow-up. Notably, more than half of infection events presented beyond six months after surgery, including late-onset cases occurring more than one year postoperatively. Revision surgery, active skin inflammation, smoking history, and unfavorable postoperative behaviors were associated with increased infection risk. Early localized infections could be considered for conservative management under close surveillance, whereas persistent or progressive infections required implant removal.
CONCLUSIONS: In this large-sample, long-term retrospective study of East Asian patients, a consistently low infection rate was observed following ePTFE rhinoplasty. These findings suggest that structured integration of perioperative management measures, as summarized by PSMS-11, may contribute to maintaining low infection rates in high-volume clinical practice. Long-term follow-up and individualized treatment decisions remain essential.
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