Viol Anthony, Pradka Sarah P, Baumeister Steffen P, Wang Danru, Moyer Kurtis E, Zura Robert D, Olson Steven A, Zenn Michael R, Levin Scott L, Erdmann Detlev
Durham, N.C. From the Divisions of Plastic, Reconstructive, Maxillofacial, and Oral Surgery and Orthopedic Surgery, Department of Surgery, Duke University Medical Center.
Plast Reconstr Surg. 2009 Apr;123(4):1256-1263. doi: 10.1097/PRS.0b013e31819f2b5e.
Traditionally, management of exposed hardware has included irrigation and débridement, intravenous antibiotics, and likely removal of the hardware. Increasingly, the goal of wound closure without hardware removal using plastic surgical techniques of soft-tissue reconstruction has been emphasized. Identification of parameters for retaining exposed hardware may assist surgeons with management decisions and outcomes.
A current literature review was performed to identify parameters with prognostic relevance for management of exposed hardware before soft-tissue reconstruction.
The following parameters were identified as important for the potential salvage of exposed hardware with soft-tissue coverage: hardware location, infection, duration of exposure, and presence of hardware loosening.
Management of exposed hardware has included the removal of the hardware. However, if certain criteria are met--specifically, stable hardware, time of exposure less than 2 weeks, lack of infection, and location of hardware--salvage of the hardware with plastic surgical soft-tissue coverage may be a therapeutic option.
传统上，外露内固定物的处理方法包括冲洗清创、静脉使用抗生素以及可能取出内固定物。如今，越来越强调采用整形外科软组织重建技术在不取出内固定物的情况下闭合伤口。确定保留外露内固定物的参数可能有助于外科医生做出管理决策并改善治疗结果。
进行了一项当前文献综述，以确定在软组织重建前对外露内固定物进行管理时具有预后相关性的参数。
以下参数被确定为对于通过软组织覆盖潜在挽救外露内固定物很重要：内固定物位置、感染、暴露持续时间以及内固定物松动情况。
外露内固定物的处理方法包括取出内固定物。然而，如果满足某些标准——具体而言，内固定物稳定、暴露时间少于2周、无感染以及内固定物位置——采用整形外科软组织覆盖来挽救内固定物可能是一种治疗选择。
