Cleanse, Perfuse, Retain (CPR) Protocol for Management of Postoperative Infections With d-PTFE Membranes: Clinical...

Postoperative infection is a serious complication of bone augmentation procedures, potentially resulting in graft failure, basal bone resorption, and spread of infection to adjacent anatomic spaces. This paper introduces the CPR (Cleanse, Perfuse, and Retain) protocol and illustrates its clinical application in the management of low- and high-grade infections related to guided bone regeneration (GBR), particularly those involving dense polytetrafluoroethylene (d-PTFE) membranes.

The CPR protocol emphasizes thorough site decontamination, enhancement of local vascularity and oxygenation, and preservation of graft integrity when feasible. Three representative cases illustrate its clinical application and demonstrate that proper implementation can preserve the regenerative site, support substantial bone formation, reduce the need for complete graft removal, and minimize treatment delays associated with infection. This management framework assists clinicians in recognizing infection severity and selecting appropriate treatment strategies.

With appropriate and timely management, graft preservation is possible, and substantial bone regeneration can be achieved. These observations should be interpreted as hypothesis-generating, and further studies are needed to validate this approach.