Schmidt-Braekling Tom, Streitbuerger Arne, Gosheger Georg, Boettner Friedrich, Nottrott Markus, Ahrens Helmut, Dieckmann Ralf, Guder Wiebke, Andreou Dimosthenis, Hauschild Gregor, Moellenbeck Burkhard, Waldstein Wenzel, Hardes Jendrik
Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA.
Eur J Orthop Surg Traumatol. 2017 May;27(4):483-489. doi: 10.1007/s00590-017-1933-9. Epub 2017 Mar 6.
Periprosthetic infection remains one of the most serious complications following megaendoprostheses. Despite a large number of preventive measures that have been introduced in recent years, it has not been possible to further reduce the rate of periprosthetic infection. With regard to metallic modification of implants, silver in particular has been regarded as highly promising, since silver particles combine a high degree of antimicrobial activity with a low level of human toxicity. This review provides an overview of the history of the use of silver as an antimicrobial agent, its mechanism of action, and its clinical application in the field of megaendoprosthetics. The benefits of silver-coated prostheses could not be confirmed until now. However, a large number of retrospective studies suggest that the rate of periprosthetic infections could be reduced by using silver-coated megaprostheses.
假体周围感染仍然是大型内置假体植入后最严重的并发症之一。尽管近年来已采取了大量预防措施，但仍无法进一步降低假体周围感染率。关于植入物的金属改性，特别是银被认为极具前景，因为银颗粒兼具高度抗菌活性和低人体毒性。本文综述了银作为抗菌剂的使用历史、作用机制及其在大型内置假体领域的临床应用。迄今为止，银涂层假体的益处尚未得到证实。然而，大量回顾性研究表明，使用银涂层大型假体可降低假体周围感染率。
