已经够了:在严重的周围假肢关节感染中进行救援程序
Yves Gramlich1, Javad Parvizi2
1Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt Am Main, Frankfurt, 60389, Germany. yves.gramlich@bgu-frankfurt.de.
Arthroplasty (London, England)
|July 2, 2023
概括
在治疗方案失败时,救援程序为严重的周围假肢关节感染提供了替代方案. 这些包括截肢,关节切除或脱bridement,抗生素和植入物保留,旨在控制感染和保持移动性.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 重建性手术是一种重建性手术.
背景情况:
- 严重的周围假肢关节感染 (PJI) 带来了治疗挑战,特别是在负宿主因素的情况下.
- 当治愈性的两阶段交换关节整形术不可行时,需要进行救援手术.
- 决策涉及平衡治疗疗法与PJI的救援选项.
研究的目的:
- 审查严重的部和膝盖周围假肢关节感染的救援程序.
- 分析各种救援技术的指示和结果.
- 为管理复杂的PJI案件提供指导.
主要方法:
- 对严重PJI的救援程序的文献综述.
- 专注于截肢,关节切除,抗生素抑制,持久性囊和脱bridement,抗生素和植入物保留 (DAIR).
- 评估局部抗生素在救援治疗中的作用.
主要成果:
- 截肢可以治愈,但在老年患者中结果有限.
- 关节切除术提供四肢救援和减少疼痛,当修复关节整形不是一个选择.
- 当手术是不可能的,终身抗生素抑制或管理持久是选择;局部抗生素的DAIR是一种有希望但有限的选择.
结论:
- 当黄金标准 (假肢交换) 由于患者因素或感染复发而不可行时,救援程序至关重要.
- 这些程序可以实现暂时缓解并保持患者的流动性.
- 对于预期寿命缩短或宿主因子负面的患者来说,考虑救援选择至关重要.
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