Baumeister S, Levin L S, Erdmann D
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Chirurg. 2006 Jul;77(7):616-21. doi: 10.1007/s00104-006-1157-8.
In the event of exposed hardware from reconstructive surgery, it must be decided whether to retain or remove it prior to plastic surgical soft-tissue reconstruction to ensure long-term freedom from infection and stable wound closure.
Treatment options and results in the literature are reviewed. A treatment algorithm is proposed under consideration of our personal experience.
Hardware used in spine surgery is commonly left in situ until bony consolidation has been achieved. The indications for hardware removal depend on length of exposure or infection, implant failure, and location. Osteosynthetic devices in the extremities may be removed and replaced by external fixators or immobilisation. Removal of prostheses requires complex second-stage reimplantation or arthrodesis. A treatment algorithm is suggested that might ease the decision whether exposed hardware can remain or requires removal before reconstruction of soft-tissue defects.
在重建手术中出现硬件暴露的情况时，必须在进行整形手术软组织重建之前决定是保留还是移除该硬件，以确保长期无感染并实现伤口的稳定闭合。
回顾文献中的治疗选择和结果。结合我们的个人经验提出一种治疗算法。
脊柱手术中使用的硬件通常留在原位，直至实现骨融合。移除硬件的指征取决于暴露时间或感染情况、植入物失败以及位置。四肢的骨合成装置可以移除，并用外固定器或固定装置替代。假体的移除需要复杂的二期再植入或关节融合术。建议采用一种治疗算法，这可能有助于在重建软组织缺损之前决定暴露的硬件是可以保留还是需要移除。
