Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey.
ENDO-Klinik Hamburg, Holstenstraße 2, 22767, Hamburg, Germany.
Arch Orthop Trauma Surg. 2022 Jul;142(7):1681-1687. doi: 10.1007/s00402-021-04061-1. Epub 2021 Jul 11.
Periprosthetic joint infection (PJI) is one of the most dreaded and challenging complications after total joint arthroplasty (TJA). The aim of this study was to evaluate the effect of keeping the dressing without change on the occurrence of PJI in patients undergoing TJA.
4877 Patients with a minimum follow-up of 90 days were included to investigate the effect of dressing on the PJI occurring within 3 months of surgery. Patients were divided into two consecutive groups as the intermittent change of traditional dressing (group 1-before 2019) and keeping dressing for 5 days without change (group 2-after 2019). A backward stepwise logistic regression model was used to estimate independent risk factors for PJI.
Group 1 and group 2 consisted of 4172 and 705 patients, and the numbers of diagnosed PJI cases in the groups were 40 (1.0%) and 10 (1.4%), respectively (p = 0.1). The backward stepwise logistic regression model analysis revealed that keeping the dressing unchanged and removing it after the first week postoperatively was not an independent risk factor for the occurrence of PJI. Older age, diabetes mellitus and coronary artery diseases were independent risk factors for PJI (p < 0.05).
Our study results present, that intermittent change of conventional dressing is unnecessary, because it does not decrease the risk of PJI after TJA.
Level III Therapeutic.
假体周围关节感染（PJI）是全关节置换术后（TJA）最可怕和最具挑战性的并发症之一。本研究旨在评估 TJA 术后不更换敷料是否会影响 PJI 的发生。
共纳入 4877 例至少随访 90 天的患者，以研究敷料对术后 3 个月内发生 PJI 的影响。患者分为两组：传统敷料间断更换组（2019 年前为组 1）和 5 天不更换敷料组（2019 年后为组 2）。采用后退逐步逻辑回归模型估计 PJI 的独立危险因素。
组 1 和组 2 分别包括 4172 例和 705 例患者，两组确诊 PJI 病例数分别为 40 例（1.0%）和 10 例（1.4%）（p=0.1）。后退逐步逻辑回归模型分析显示，不更换敷料且术后第一周去除敷料不是 PJI 发生的独立危险因素。年龄较大、糖尿病和冠状动脉疾病是 PJI 的独立危险因素（p<0.05）。
我们的研究结果表明，TJA 后，传统敷料的间断更换是不必要的，因为它不会降低 PJI 的风险。
治疗性 III 级。
