Rothman Institute of Orthopedics at Thomas Jefferson University, Department of Orthopedic Surgery, Thomas Jefferson University Hospital Rothman Institute, Philadelphia, Pennsylvania 19107, USA.
J Arthroplasty. 2010 Oct;25(7):1022-7. doi: 10.1016/j.arth.2010.01.104. Epub 2010 Apr 8.
Irrigation and debridement (I and D) is a procedure commonly used for the treatment of acute periprosthetic infection. This study retrospectively reviewed clinical records of patients with periprosthetic infection of the hip or knee who underwent I and D with retention of their prostheses between 1997 and 2005 at a single institution. One hundred four patients (44 males and 60 females) were identified. Mean age at time of initial debridement was 65 years. Average follow-up was 5.7 years. Treatment failure was defined as the need for resection arthroplasty or recurrent microbiologically proven infection. According to these criteria, I and D was successful in 46 patients (44%). Patients with staphylococcal infection, elevated American Society of Anesthesiologists score, and purulence around the prosthesis were more likely to fail. The high failure rate of this procedure implies that it should be preferably limited to select healthy patients with low virulence organisms and equivocal intraoperative findings.
清创术（I 和 D）是一种常用于治疗急性人工关节周围感染的方法。本研究回顾性分析了 1997 年至 2005 年在一家医疗机构接受 I 和 D 治疗且保留假体的髋关节或膝关节人工关节周围感染患者的临床记录。共确定了 104 例患者（44 名男性和 60 名女性）。初次清创时的平均年龄为 65 岁。平均随访时间为 5.7 年。治疗失败的定义为需要进行关节切除成形术或复发性微生物学证实的感染。根据这些标准，46 例（44%）患者的 I 和 D 治疗成功。金黄色葡萄球菌感染、美国麻醉医师协会评分升高和假体周围有脓液的患者更有可能失败。该手术的高失败率表明，它最好仅限于选择健康、低毒力病原体和术中发现不明确的患者。
