儿科I型开放的骨骨折:仅抗生素是否足够?
Rory F L Hammond1, Nikhil Manoj2, Anna Bridgens3
1The Royal London Hospital, London, UK.
对于儿科Gustilo-Anderson I型开放的骨骨折,使用抗生素进行非手术治疗显示的感染率与手术除相似. 需要进一步的高质量证据来指导这些儿科骨折的治疗决策.
科学领域:
- 整形外科手术 整形外科手术
- 儿科创伤 儿童创伤
- 传染性疾病 传染性疾病
背景情况:
- 开放性骨折的传统管理包括新兴的脱bridement.
- 有证据表明,对于儿科Gustilo-Anderson型I开放骨折,这种方法应该受到质疑.
研究的目的:
- 系统地审查感染率,比较非手术治疗 (抗生素) 与手术脱bridement.
- 专注于儿科I类型的开放下肢骨折,无需进行手术固定.
主要方法:
- 按照PRISMA指南进行系统审查.
- 包括18岁以下的I型开放骨骨折的患者.
- 不包括多创伤和需要操作稳定的人.
- 使用ROBINS-I工具进行评估偏差.
主要成果:
- 分析了10项回顾性研究 (123名患者).
- 非手术组 (41名患者):感染率为4.87% (2/41).
- 手术除菌组 (82名患者):感染率为2.33% (2/82).
结论:
- 对于小儿I型开放骨折的最佳管理仍然不清楚.
- 选择的低能量的伤害可以在急诊室进行非手术治疗.
- 没有足够的高质量证据经常偏离当前的指导方针;考虑能量吸收.
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