義眼床作製時におけるアルギン酸塩繊維の臨床使用経験

Use of calcium alginate for the eye socket wound dressing

要約　目的：眼球内容除去後の術創処理にアルギン酸塩膜を使用した症例の報告。症例：64歳女性が右眼の角膜穿孔と水晶体脱出で紹介受診した。35年前から関節リウマチでステロイドを内服し，10年前に線維柱帯切除術後に眼内炎となり，2か月前から角膜感染の徴候があった。経過：抗生物質の投与後に右眼の眼球内容除去術を行った。結膜を縫合して義眼床を作製し，アルギン酸塩膜でカバーした綿球を結膜囊に挿入した。包帯交換時の疼痛は軽く，創部からの出血や二次損傷はなかった。術後10日目に仮義眼を装用できた。結論：眼球内容除去後の創傷処理にアルギンシートを使用し，疼痛軽減，感染防止，創部保護，止血効果があり，義眼床作製に有用であった。

Abstract.　Purpose：To report treatment of wound using calcium alginate sheet in a case after evisceration. Case：A 64-year-old woman was referred to us for corneal perforation with lens prolapse in the right eye. She had been treated with systemic corticosteroid for rheumatic arthritis for 35 years. Trabeculectomy had been followed by endophthalmitis 10 years ago. Signs of corneal infection had been present since 2 months ago. Clinical Course：The right eye was eviscerated following systemic antibiotics for 3 days. Cotton ball covered with alginate was packed into the eye socket. The packing was changed every day or on alternate days. There was no pain during dressing changes,hemorrhage,or secondary damage to the wound. Conclusion：Use of alginate in dressing the wound was useful in alleviating pain,prevention of infection,protection of the wound,prevention of hemorrhage,and preparing the eye socket for prosthetics.