一本关于脱bridement,抗生素和植入物保留的指南
Kenneth Vaz1, Adrian Taylor1, Ben Kendrick1
1Nuffield Orthopaedic Centre and University of Oxford, Botnar Research Centre, Oxford, UK.
Annals of joint
|March 26, 2024
概括
脱皮,抗生素和植入物保留 (DAIR) 为周围假肢关节感染 (PJI) 治疗提供了一个可行的替代方案. 尽管根除率较低,但与交换关节整形相比,DAIR在发病率,功能和成本方面提供了显著的好处.
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
- 关节整形管理 关节整形管理
背景情况:
- 周围假肢关节感染 (PJI) 在关节整形术中构成了重大挑战.
- 传统的治疗方法,如一个或两个阶段的交换关节整形术,患病率和成本都很高.
- 脱皮,抗生素和植入物保留 (DAIR) 提出了一个替代的管理策略.
研究的目的:
- 介绍部和膝盖PJI中DAIR的指示,考虑和技术.
- 为了突出DAIR与传统交换关节整形相比的好处.
- 强调成功DAIR结果的关键因素.
主要方法:
- 手术除与彻底的组织去除.
- 适当的抗生素的管理.
- 在可行的情况下,更换模块化组件.
- 涉及多学科团队 (MDT),包括传染病专家.
主要成果:
- 戴尔可以实现与未感染病例相比较的植入物寿命.
- 益处包括降低发病率,改善功能结果和降低成本.
- 精细的除菌和准确的组织采样对于成功至关重要.
结论:
- DAIR是PJI的有价值的治疗选择,平衡风险和收益.
- 成功的DAIR需要经验丰富的外科技术和MDT合作.
- DAIR不应被视为一个简单的"清洗",而是一个最终的程序.
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