局部抗生素递送系统在糖尿病足骨髓炎中的应用：简要综述。
Local Antibiotic Delivery Systems in Diabetic Foot Osteomyelitis: A Brief Review.
机构信息
Department of Orthopaedic Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Diabetes Centre - Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
出版信息
Rev Diabet Stud. 2021 Nov 1;17(2):75-81. doi: 10.1900/RDS.2021.17.75.
Diabetic foot osteomyelitis (DFO) is a severe, difficult to treat infection. Local antibiotic delivery has been studied as a potential therapeutic adjunct following surgery for DFO. This review aims to summarize the evidence on local antibiotic delivery systems in DFO. PubMed database was searched up to March 2020. Overall, 16 studies were identified and included: 3 randomized controlled trials (RCTs), 3 retrospective studies (RSs), and 10 case series. In the RCTs, gentamicin-impregnated collagen sponges significantly improved clinical healing rates and slightly improved duration of hospitalization. In the RSs, antibiotic-impregnated calcium sulfate beads non-significantly improved all healing parameters, but did not reduce post-operative amputation rates or time of healing. The majority of case series used calcium sulfate beads, achieving adequate rates of healing and eradication of infection. In conclusion, evidence for add-on local antibiotic delivery in DFO is still limited; more data are needed to assess this therapeutic measure.
糖尿病足骨髓炎（DFO）是一种严重且难以治疗的感染。局部抗生素给药已被研究作为 DFO 手术后的一种潜在治疗辅助手段。本综述旨在总结 DFO 局部抗生素给药系统的证据。检索了截至 2020 年 3 月的 PubMed 数据库。共确定并纳入了 16 项研究：3 项随机对照试验（RCT）、3 项回顾性研究（RS）和 10 项病例系列研究。在 RCT 中，庆大霉素浸渍胶原海绵显著提高了临床愈合率，并略微缩短了住院时间。在 RS 中，抗生素浸渍硫酸钙珠并未显著改善所有愈合参数，但并未降低术后截肢率或愈合时间。大多数病例系列研究使用硫酸钙珠，达到了足够的愈合率和消除感染。总之，DFO 中局部抗生素辅助给药的证据仍然有限；需要更多的数据来评估这种治疗措施。
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