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针道感染:预防策略的系统评价

Pin-site Infection: A Systematic Review of Prevention Strategies.

作者信息

Shields David W, Iliadis Alexis-Dimitris, Kelly Erin, Heidari Nima, Jamal Bilal

机构信息

Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom.

Limb Reconstruction and Bone Infection Service, Barts Bone and Joint Health, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.

出版信息

Strategies Trauma Limb Reconstr. 2022 May-Aug;17(2):93-104. doi: 10.5005/jp-journals-10080-1562.

Abstract

INTRODUCTION

Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains.

AIM

The principal aim of this review is to synthesise primary research concerning all aspects of treatment regarded as relevant to PSI in frame constructs.

MATERIALS AND METHODS

Comparative studies until week 26, 2021, were included in the trial. Studies were included that concerned patients undergoing management of a musculoskeletal condition in which pin-site care is necessary for over 4 weeks.

RESULTS

Eighteen studies over a 13-year period were captured using the search strategy. Sulphadiazine and hydrogen peroxide cleansing was found to reduce PSI, with the use of low-energy fine wires and hydroxyapatite (HA)-coated pins also associated with lower infection rate. The remainder of studies found no significant improvement across interventions.

CONCLUSION

There is no superiority between weekly and daily care. Low-energy pin-insertion technique had lower rates of infection. Sulphadiazine has positive results as a pin-care solution, but more research is necessary to determine the most effective care regime. Current literature is limited by absence of established definitions and by a lack of studies addressing all aspects of care relevant to PSI.

HOW TO CITE THIS ARTICLE

Shields DW, Iliadis AD, Kelly E, . Pin-site Infection: A Systematic Review of Prevention Strategies. Strategies Trauma Limb Reconstr 2022;17(2):93-104.

摘要

引言

环形外固定架固定仍然是肢体重建外科医生的重要工具之一。其主要缺点之一是针道感染(PSI)的发生。由于预防针道感染的证据有限且缺乏共识,目前的实践差异很大。

目的

本综述的主要目的是综合关于外固定架结构中与针道感染相关的所有治疗方面的初步研究。

材料与方法

纳入截至2021年第26周的比较研究。纳入的研究涉及接受肌肉骨骼疾病治疗的患者,其中针道护理需要超过4周。

结果

使用检索策略在13年期间共纳入18项研究。发现磺胺嘧啶和过氧化氢清洗可降低针道感染,使用低能量细钢丝和羟基磷灰石(HA)涂层针也与较低的感染率相关。其余研究发现各干预措施之间无显著改善。

结论

每周护理和每日护理之间没有优越性。低能量穿针技术的感染率较低。磺胺嘧啶作为针道护理溶液有积极效果,但需要更多研究来确定最有效的护理方案。目前的文献因缺乏既定定义以及缺乏涉及与针道感染相关的所有护理方面的研究而受到限制。

如何引用本文

希尔兹DW,伊利亚迪斯AD,凯利E,等。针道感染:预防策略的系统评价。创伤肢体重建策略2022;17(2):93 - 104。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ad0/9357789/2c668dba5778/stlr-17-93-g001.jpg

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