冲洗液和抗生素粉剂：在初次和翻修全膝关节置换术中，我应该使用它们吗？
Irrigation Solutions and Antibiotic Powders: Should I Use Them in Primary and Revision Total Joint Arthroplasty?
机构信息
OrthoCarolina Hip and Knee Center, Atrium Musculoskeletal Institute, Charlotte, NC.
出版信息
J Arthroplasty. 2022 Aug;37(8):1438-1440. doi: 10.1016/j.arth.2022.02.096. Epub 2022 Mar 2.
BACKGROUND
The prevention and treatment of periprosthetic joint infection is of utmost importance to orthopedic surgeons. Irrigation solutions have become a popular additive to the prevention and treatment armamentarium.
METHODS
This symposium summarizes the mechanism of action, basic science, and clinical research to date on the use of irrigation solutions. The four most commonly used irrigation solutions, povidone iodine, chlorhexidine, hydrogen peroxide, and acetic acid, are discussed. In addition, the role of antibiotic powers is reviewed.
RESULTS
Each solution has its risks and benefits that must be weighed by the surgeon. There is no clear irrigation solution that is superior. The role of additive antibiotic powder (vancomycin) remains controversial.
CONCLUSION
More rigorous prospective clinical trials are needed to determine the optimal irrigation solution for the prevention and treatment of periprosthetic joint infection.
背景
预防和治疗人工关节周围感染对矫形外科医生来说至关重要。灌洗溶液已成为预防和治疗手段的常用添加剂。
方法
本次研讨会总结了迄今为止关于灌洗溶液使用的作用机制、基础科学和临床研究。讨论了四种最常用的灌洗溶液，即聚维酮碘、洗必泰、过氧化氢和醋酸。此外，还回顾了抗生素粉末的作用。
结果
每种溶液都有其风险和益处，这需要由外科医生权衡。没有一种灌洗溶液具有明显优势。添加抗生素粉末（万古霉素）的作用仍存在争议。
结论
需要进行更严格的前瞻性临床试验，以确定预防和治疗人工关节周围感染的最佳灌洗溶液。
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