Giannoudis Peter V, Tosounidis Theodoros H
Leeds General Infirmary, Leeds, West Yorkshire, UK.
University Hospital, Heraklion, Crete, Greece.
OTA Int. 2020 Mar 23;3(1):e068. doi: 10.1097/OI9.0000000000000068. eCollection 2020 Mar.
Acute and chronic infections with bone involvement remain a challenge to manage. They pose a significant burden to the patient, the treating surgeon, and society. Multidisciplinary team involvement is mandatory for a successful outcome. Application of a gold standard approach is not possible due to the high heterogeneous patient population and the variable degree of severity of soft tissue and bone involvement. The mainstay of treatment remains the conversion of a septic environment to an aseptic one with aggressive debridement of the affected soft tissues and bone. Reconstruction of the soft tissue defect can be achieved using modern microsurgical techniques, whereas the induced membrane and distraction osteogenesis (bone transport) are currently the 2 most commonly used treatment modalities for bone loss. The safest approach to deal successfully with this multifaceted clinical pathology is to always follow well-established principles of management and adapt treatment to the personalized needs of the patient.
伴有骨受累的急慢性感染在治疗上仍然是一项挑战。它们给患者、主治外科医生和社会带来了沉重负担。多学科团队的参与对于取得成功的治疗结果至关重要。由于患者群体高度异质性以及软组织和骨受累的严重程度各不相同，因此无法应用金标准方法。治疗的主要支柱仍然是通过积极清创受影响的软组织和骨，将感染环境转变为无菌环境。软组织缺损的重建可以使用现代显微外科技术来实现，而诱导膜和牵张成骨术（骨搬运）目前是治疗骨缺损最常用的两种治疗方式。成功应对这种多方面临床病理的最安全方法是始终遵循既定的管理原则，并根据患者的个性化需求调整治疗方案。
