Department of Orthopedic Oncology and Septic Orthopedic Surgery, Orthopedic University Hospital, Heidelberg, Germany.
Int Orthop. 2011 Sep;35(9):1415-20. doi: 10.1007/s00264-011-1274-y. Epub 2011 May 17.
Infections associated with orthopaedic implants remain a serious complication. The main objective in acute infection control is component retention, whereas this option is usually not considered for chronic infections.
This multi-centre prospective, non-randomised observational study investigated one possible treatment option for implant retention in combination with negative pressure wound therapy with instillation (NPWTi). Thirty-two patients with an infected orthopaedic implant were analysed. Twenty-two patients had an acute infection (< 8 weeks after implantation) and ten patients had a chronic infection (> 8 weeks and < 36 weeks after implant placement). Polyhexanide was used as the instillation solution in 31 of the 32 cases.
Nineteen patients (86.4%) with an acute infection and eight patients (80%) with a chronic infection retained their implant at 4-6 months follow-up after treatment.
Our study showed that NPWTi can be used as adjunctive therapy for salvage of acutely infected orthopaedic implants and may even be considered for early chronically infected implants.
与骨科植入物相关的感染仍然是一个严重的并发症。急性感染控制的主要目标是保留植入物，而对于慢性感染通常不考虑这种选择。
这项多中心前瞻性、非随机观察性研究调查了一种可能的治疗选择，即保留植入物并结合负压伤口治疗（NPWTi）进行灌洗。分析了 32 例感染性骨科植入物患者。22 例为急性感染（植入后<8 周），10 例为慢性感染（植入后>8 周且<36 周）。在 32 例中，有 31 例使用聚己双胍作为灌洗溶液。
19 例（86.4%）急性感染患者和 8 例（80%）慢性感染患者在治疗后 4-6 个月随访时保留了植入物。
我们的研究表明，NPWTi 可作为急性感染骨科植入物挽救治疗的辅助疗法，甚至可考虑用于早期慢性感染的植入物。
