整体关节整形手术的例行手术前牙清除:有没有好处?
Stephanie A Kwan1, Vincent Lau1, Brian E Fliegel1
1Orthopaedic Surgery, Jefferson Health New Jersey, Stratford, USA.
Cureus
|August 7, 2023
概括
在全面关节整形手术 (TJA) 之前的例行手术前牙清除不会显著影响周围假肢关节感染 (PJI) 率或微生物概况. 消除这种查可能是合理的,减少了接受TJA的患者的成本和延迟.
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
- 公共卫生 公共卫生
背景情况:
- 周围假肢关节感染给患者和医疗保健系统带来了巨大的负担.
- 术前牙科查是减轻PJI风险的建议措施,但缺乏共识.
- 目前的做法各不相同,需要基于证据的指导.
研究的目的:
- 调查手术前牙清除对PJI率的影响.
- 分析牙清洁和没有牙清洁的患者之间的微生物概况差异.
- 为了评估PJI率的变化,在牙科清除协议的修改后.
主要方法:
- 对8654名接受初级全关节或膝关节关节整形手术的患者 (2017-2021) 的回顾性审查.
- 匹配的队列:有例行牙清除的患者与没有牙清除的患者.
- 在外科医生改变牙清除协议之前和之后的PJI率的比较.
主要成果:
- 在接受牙清除和不接受牙清除的患者之间没有观察到PJI率的统计学上显著差异.
- 在外科医生改变手术方案之前和之后,PJI率没有显著差异.
- 在两组患者中,PJI中的微生物概况在两组患者中都是相似的.
结论:
- 消除可选全关节整形术 (TJA) 的常规术前牙清除似乎不会增加PJI的发生率或改变感染概况.
- 选择性牙科查可能是一个可行的替代方案,可能降低患者成本和护理延迟.
- 有证据支持在TJA协议中重新考虑强制性手术前牙科清除.
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