Marberry Kevin M, Kazmier Pete, Simpson W Andrew, Christensen Gordon D, Phaup J Glenn, Hendricks Kelly J, Anglen Jeffrey O, Gainor Barry J
Department of Orthopaedic Surgery, University of Missouri-Columbia, Columbia, MO, 65212, USA.
Clin Orthop Relat Res. 2002 Oct(403):73-9. doi: 10.1097/00003086-200210000-00012.
Deep wound infection involving an implanted biomaterial is a devastating complication in orthopaedic surgery. Two-thirds of such infections are monomicrobial and the most commonly isolated bacteria in human osteomyelitis and orthopaedic device infection are Staphylococcus aureus and Staphylococcus epidermidis. The purpose of the current study was to examine the effectiveness of the previously reported sequential surfactant irrigation protocol against human-isolated clinical strains of Staphylococcus aureus and Staphylococcus epidermidis in the rat model of orthopaedic implant contamination. The infectivity rate of human-isolated clinical strains of Staphylococcus aureus in a contaminated complex orthopaedic wound was reduced effectively by a sequential surfactant irrigation protocol. Also, in this model, the infectivity of Staphylococcus epidermidis was reduced by normal saline irrigation alone when compared with no irrigation. Therefore, the sequential surfactant irrigation protocol may represent an effective method of wound irrigation in monomicrobial Staphylococcus aureus orthopaedic implant contamination, and normal saline irrigation may suffice in cases of monomicrobial Staphylococcus epidermidis contamination. Additional studies are necessary to determine the clinical use of surfactant irrigation.
涉及植入生物材料的深部伤口感染是骨科手术中一种极具破坏性的并发症。此类感染中有三分之二为单一微生物感染，在人类骨髓炎和骨科器械感染中最常分离出的细菌是金黄色葡萄球菌和表皮葡萄球菌。本研究的目的是在骨科植入物污染的大鼠模型中，检验先前报道的序贯表面活性剂冲洗方案对从人类分离出的金黄色葡萄球菌和表皮葡萄球菌临床菌株的有效性。序贯表面活性剂冲洗方案有效降低了污染复杂骨科伤口中从人类分离出的金黄色葡萄球菌临床菌株的感染率。此外，在该模型中，与不冲洗相比，仅用生理盐水冲洗就能降低表皮葡萄球菌的感染性。因此，序贯表面活性剂冲洗方案可能是单一微生物金黄色葡萄球菌骨科植入物污染伤口冲洗的有效方法，而单一微生物表皮葡萄球菌污染的情况下，生理盐水冲洗可能就足够了。需要进一步研究以确定表面活性剂冲洗的临床应用。
