在急性周围假肢关节感染中优化除菌和植入物保留
Andreas Fontalis1,2, Adam T Yasen1, Dia E Giebaly1
1Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
The bone & joint journal
|November 30, 2024
概括
脱bridement,抗生素和植入物保留 (DAIR) 协议是围围假肢关节感染 (PJI) 的关键治疗方法. 这一分析探讨了DAIR.
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
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJI) 在骨科手术中带来了重大挑战,导致高发病率和医疗费用.
- 脱bridement,抗生素和植入物保留 (DAIR) 协议为PJI管理提供了与植入物修订相比的优势.
- 不断发展的战略旨在提高DAIR的有效性,包括对急性PJI进行阶段性脱bridement.
研究的目的:
- 为周围假肢关节感染 (PJI) 提供除菌,抗生素和植入物保留 (DAIR) 协议的全面分析.
- 评估单阶段,两阶段和重复的DAIR程序的结果.
- 讨论影响DAIR协议选择的挑战和关键因素.
主要方法:
- 对PJI的DAIR协议现有文献的审查.
- 对单阶段,两阶段和重复的DAIR程序的结果分析.
- 识别和讨论包括患者因素,病原体识别,手术技术和抗生素选择在内的挑战.
主要成果:
- 包括分阶段方法在内的DAIR协议对于PJI管理是可行的.
- 在单阶段,两阶段和重复的DAIR程序中,结果各不相同.
- 患者异质性,病原体识别,手术变异性和抗生素选择影响DAIR的成功.
结论:
- DAIR 协议需要仔细考虑许多因素,以获得最佳的 PJI 治疗.
- 在单阶段和双阶段DAIR之间做出明智的决策取决于团队的专业知识,时间,抗生素以及患者/植入物因素.
- 在DAIR策略的进一步进展对于改善PJI管理中的患者结果至关重要.
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