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人工关节感染治疗/预防的术中注意事项

Intraoperative Considerations for Treatment/Prevention of Prosthetic Joint Infection.

作者信息

Suleiman Linda I, Mesko Daniel R, Nam Denis

机构信息

Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison St, Chicago, IL, 60612, USA.

出版信息

Curr Rev Musculoskelet Med. 2018 Sep;11(3):401-408. doi: 10.1007/s12178-018-9502-3.

Abstract

PURPOSE OF REVIEW

Innovative measures have recently been proposed to prevent periprosthetic joint infection following total hip and knee arthroplasty. We sought to review these recent innovations to determine the reported reduction in periprosthetic joint infection.

RECENT FINDINGS

The most recent literature demonstrates promising results in regard to hydrofiber dressings as an independent risk factor for primary prosthetic joint infection reduction, which in turn is also linked with cost savings. As our understanding of safe yet effective concentrations of antiseptic solutions develops, dilute betadine in particular has demonstrated encouraging efficacy which warrants continued investigation through controlled trials. In summary, we found that the application of a hydrofiber dressing may prove beneficial in decreasing the risk of prosthetic joint infection following primary total hip and knee arthroplasty. The gold standard for an infection prevention protocol continues to be explored and optimized.

摘要

综述目的

最近有人提出了创新措施来预防全髋关节和膝关节置换术后的假体周围关节感染。我们试图回顾这些近期的创新措施,以确定所报道的假体周围关节感染减少情况。

最新发现

最新文献表明,水凝胶敷料作为降低原发性假体关节感染的独立危险因素取得了令人鼓舞的结果,这反过来也与成本节约相关。随着我们对安全且有效的防腐剂溶液浓度的认识不断发展,特别是稀释的碘伏已显示出令人鼓舞的疗效,值得通过对照试验继续进行研究。总之,我们发现应用水凝胶敷料可能有助于降低初次全髋关节和膝关节置换术后假体关节感染的风险。预防感染方案的金标准仍在不断探索和优化。

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本文引用的文献

1
The effect of wound dressings on infection following total joint arthroplasty.
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In search of the optimal wound dressing material following total hip and knee arthroplasty: a systematic review and meta-analysis.
Int Orthop. 2017 Jul;41(7):1295-1305. doi: 10.1007/s00264-017-3484-4. Epub 2017 May 11.
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Poor Outcomes of Irrigation and Debridement in Acute Periprosthetic Joint Infection With Antibiotic-Impregnated Calcium Sulfate Beads.
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