Fontanesi G, Costa P, Giancecchi F, Tartaglia I, Rotini R
Ia. Divisione, Istituto Ortopedico Rizzoli, Bologna.
Chir Organi Mov. 1991 Apr-Jun;76(2):133-43.
The prevention of deep sepsis and venous thromboembolism in knee replacement surgery is of great importance for the final success of treatment. General rules of prevention must be followed when using antimicrobial drugs (environment, surgical method, patient selection). Although it does have some negative aspects (overuse, high costs, development of resistant bacteria) the administration of antibiotics is recommended, but only when it is timely, correct, and carried out for a suitable amount of time. The prevention of thromboembolism is based first on the selection of patients who risk the occurrence of angiology-related diseases, on continuous passive postoperative movement, and, finally, on intentional normovolemic hemodilution, for which the procedures used and the advantages obtained are described.
膝关节置换手术中预防深部脓毒症和静脉血栓栓塞对于治疗的最终成功至关重要。使用抗菌药物时必须遵循一般预防原则(环境、手术方法、患者选择)。尽管使用抗生素存在一些负面影响(过度使用、高成本、耐药菌的产生),但仍建议使用抗生素,前提是用药及时、正确且持续适当时间。预防血栓栓塞首先基于对有血管相关疾病发生风险的患者进行选择,术后持续进行被动活动,最后是进行有意的正常血容量血液稀释,并描述了所使用的方法及获得的益处。