Suppr超能文献

肥胖患者初次全膝关节置换术后延长口服抗生素能否预防早期假体周围关节感染?

Do Extended Oral Postoperative Antibiotics Prevent Early Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Primary Total Joint Arthroplasty?

机构信息

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA.

出版信息

J Arthroplasty. 2021 Aug;36(8):2716-2721. doi: 10.1016/j.arth.2021.03.018. Epub 2021 Mar 8.

Abstract

BACKGROUND

Extended oral antibiotic prophylaxis after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) in patients with body mass index (BMI) ≥40 kg/m may reduce the rate of early periprosthetic joint infection (PJI); however, existing data are limited. The purpose of this study was to examine rates of wound complications and PJI in patients with BMI ≥40 kg/m treated with and without extended oral antibiotic prophylaxis after surgery.

METHODS

We retrospectively identified all primary THA and TKA performed since 2015 in patients with a BMI ≥40 kg/m at a single institution. Extended oral antibiotic prophylaxis for 7-14 days after surgery was prescribed at the discretion of each surgeon. Wound complications and PJI were examined at 90 days postoperatively.

RESULTS

In total, 650 cases (205 THA and 445 TKA) were analyzed. Mean age was 58 years and 62% were women. Mean BMI was 44 kg/m. Extended oral antibiotic prophylaxis was prescribed in 177 cases (27%). At 90 days, there was no difference between prophylaxis and nonprophylaxis groups in rate of wound complications (11% vs 8%; P = .41) or PJI (1.7% vs 0.6%; P = .35). The univariate analysis demonstrated increased operative time (odds ratio (OR) 1.01; 95% confidence interval (95% CI) 1.01-1.02) and diabetes mellitus (OR 1.88; 95% CI 1.03-3.46) to be associated with increased risk of 90-day wound complications. No patient factors were associated with increased risk of PJI at 90 days postoperatively.

CONCLUSION

Extended oral antibiotic prophylaxis after primary THA and TKA did not reduce rates of wound complications or early PJI in a morbidly obese patient population.

摘要

背景

对于身体质量指数(BMI)≥40kg/m²的初次全膝关节置换术(TKA)和全髋关节置换术(THA)患者,延长术后口服抗生素预防治疗可能会降低早期假体周围关节感染(PJI)的发生率;然而,目前的数据有限。本研究旨在评估 BMI≥40kg/m²的患者接受和不接受术后延长口服抗生素预防治疗后的伤口并发症和 PJI 发生率。

方法

我们回顾性地确定了自 2015 年以来在一家医疗机构中 BMI≥40kg/m²的所有初次 THA 和 TKA 患者。术后是否延长口服抗生素预防治疗由每位外科医生自行决定。在术后 90 天评估伤口并发症和 PJI。

结果

共分析了 650 例(205 例 THA 和 445 例 TKA)病例。平均年龄为 58 岁,62%为女性。平均 BMI 为 44kg/m²。177 例(27%)患者接受了延长口服抗生素预防治疗。在术后 90 天时,预防组和非预防组在伤口并发症发生率(11%比 8%;P=0.41)或 PJI 发生率(1.7%比 0.6%;P=0.35)方面没有差异。单因素分析表明,手术时间延长(比值比(OR)1.01;95%置信区间(95%CI)1.01-1.02)和糖尿病(OR 1.88;95%CI 1.03-3.46)与术后 90 天伤口并发症的风险增加相关。没有患者因素与术后 90 天 PJI 的风险增加相关。

结论

对于病态肥胖患者人群,初次 THA 和 TKA 后延长口服抗生素预防治疗并不能降低伤口并发症或早期 PJI 的发生率。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验