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感染性全踝关节置换术后灌洗清创保留假体(DAIR)的适应证和禁忌证有哪些?

What Are the Indications and Contraindications for Irrigation and Debridement and Retention of Prosthesis (DAIR) in Patients With Infected Total Ankle Arthroplasty (TAA)?

机构信息

1 Icahn School of Medicine at Mount Sinai, New York, NY, USA.

2 Beth Israel Deaconess Medical Center, Boston, MA, USA.

出版信息

Foot Ankle Int. 2019 Jul;40(1_suppl):52S-53S. doi: 10.1177/1071100719861099.

Abstract

RECOMMENDATION

Debridement, antibiotics, and implant retention (DAIR) with polyethylene exchange may be indicated in early postoperative infection (<4 weeks) or acute hematogenous infection (<4 weeks of symptoms) in patients with infected total ankle arthroplasty (TAA), although recurrent infection has been seen. Suffcient clinical evidence is lacking.

LEVEL OF EVIDENCE

Consensus.

DELEGATE VOTE

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).

摘要

建议

对于感染性全踝关节置换术后(TAA)早期术后感染(<4 周)或急性血源性感染(<4 周症状)的患者,可采用清创术、抗生素和植入物保留(DAIR)联合聚乙烯置换,尽管会出现反复感染。但目前尚缺乏充分的临床证据。

证据等级

共识。

代表投票

同意:100%,不同意:0%,弃权:0%(一致,最强共识)。

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