Deng Z, Liu F, Li C
Department of Orthopaedics, Beijing Changping Hospital, Beijing, China.
Department of Nursing, Weihai Municipal Hospital, Weihai, China.
Bone Joint Res. 2019 Jun 5;8(5):189-198. doi: 10.1302/2046-3758.85.BJR-2018-0280.R3. eCollection 2019 May.
Irrigation is the cornerstone of treating skeletal infection by eliminating pathogens in wounds. A previous study shows that irrigation with normal saline (0.9%) and ethylenediaminetetraacetic acid (EDTA) could improve the removal of () and () compared with normal saline (NS) alone. However, it is still unclear whether EDTA solution is effective against infection with drug-resistant bacteria.
We established three wound infection models (skin defect, bone-exposed, implant-exposed) by inoculating the wounds with a variety of representative drug-resistant bacteria including methicillin-resistant (MRSA), extended spectrum beta-lactamase-producing (ESBL-EC), multidrug-resistant (MRPA), vancomycin-resistant (VRE), multidrug-resistant (MRAB), multidrug-resistant (MRE), and multidrug-resistant (MRPM). Irrigation and debridement were repeated until the wound culture became negative. The operating times required to eliminate pathogens in wounds were compared through survival analysis.
Compared with other groups (NS, castile soap, benzalkonium chloride, and bacitracin), the EDTA group required fewer debridement and irrigation operations to achieve pathogen eradication in all three models of wound infection.
Irrigation with EDTA solution was more effective than the other irrigation fluids used in the treatment of wound infections caused by drug-resistant pathogens.: Z. Deng, F. Liu, C. Li. Therapeutic effect of ethylenediaminetetraacetic acid irrigation solution against wound infection with drug-resistant bacteria in a rat model: an animal study. 2019;8:189-198. DOI: 10.1302/2046-3758.85.BJR-2018-0280.R3.
冲洗是通过清除伤口中的病原体来治疗骨骼感染的基石。先前的一项研究表明,与单独使用生理盐水(NS)相比,用生理盐水(0.9%)和乙二胺四乙酸(EDTA)冲洗可改善()和()的清除。然而,EDTA溶液对耐药菌感染是否有效仍不清楚。
我们通过用多种代表性耐药菌接种伤口建立了三种伤口感染模型(皮肤缺损、骨外露、植入物外露),这些耐药菌包括耐甲氧西林(MRSA)、产超广谱β-内酰胺酶(ESBL-EC)、多重耐药(MRPA)、耐万古霉素(VRE)、多重耐药(MRAB)、多重耐药(MRE)和多重耐药(MRPM)。反复进行冲洗和清创,直到伤口培养结果为阴性。通过生存分析比较清除伤口中病原体所需的手术时间。
与其他组(NS、卡斯蒂利亚皂、苯扎氯铵和杆菌肽)相比,EDTA组在所有三种伤口感染模型中实现病原体根除所需的清创和冲洗操作更少。
在治疗由耐药病原体引起的伤口感染方面,用EDTA溶液冲洗比其他冲洗液更有效。:邓Z、刘F、李C。乙二胺四乙酸冲洗液对大鼠模型耐药菌伤口感染的治疗作用:一项动物研究。2019;8:189 - 198。DOI:10.1302/2046 - 3758.85.BJR - 2018 - 0280.R3。