Harrasser Norbert, Harnoss Tobias
Klinik für Orthopädie und Sportorthopädie, Klinikum Rechts der Isar der Technischen Universität München, München, Germany.
Wien Med Wochenschr. 2012 Mar;162(5-6):115-20. doi: 10.1007/s10354-011-0043-2. Epub 2012 Feb 16.
High numbers of primary joint replacement procedures lead to increasing numbers of revision surgeries due to periprosthetic joint infections. Several studies revealed different patient-associated and intervention-associated risk factors. Importance should be pointed on short operating times to avoid intraoperative colonisation of the implant with microorganisms. Patient-associated diseases such as diabetes and obesity should be influenced positively in the preoperative setting. Cessation of smoking should be started two months before surgery and continued until wound healing is completed. Intraoperative single-shot antibiotic prophylaxis has become clinical routine. Prolonged perioperative antibiotic prophylaxis is often conducted but has not shown to be effective in lowering infection rates.
大量的初次关节置换手术导致因假体周围关节感染而进行的翻修手术数量增加。多项研究揭示了不同的患者相关和干预相关风险因素。应重视缩短手术时间以避免植入物在术中被微生物定植。糖尿病和肥胖等患者相关疾病应在术前得到积极改善。应在手术前两个月开始戒烟，并持续到伤口愈合完成。术中单次预防性使用抗生素已成为临床常规操作。围手术期长期预防性使用抗生素经常进行，但尚未证明在降低感染率方面有效。
