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手术在当代骨与关节感染管理中的作用。

Surgery's role in contemporary osteoarticular infection management.

作者信息

De Marco Giacomo, Vazquez Oscar, Gavira Nathaly, Ramadani Ardian, Steiger Christina, Dayer Romain, Ceroni Dimitri

机构信息

Pediatric Orthopedics Unit, Pediatric Surgery Service, University Hospitals of Geneva, Genève, Switzerland.

出版信息

Front Pediatr. 2022 Dec 19;10:1043251. doi: 10.3389/fped.2022.1043251. eCollection 2022.

Abstract

The treatment paradigm for osteoarticular infections (OAIs) has changed drastically over the past 80 years, from the advent of penicillin to the use of broad-spectrum antibiotics. Before these drugs, surgery was the only available treatment for OAIs; today, antibiotic therapy is considered the primary response to them. As a result, surgical treatment of OAIs is thus far more rarely indicated, sometimes even considered outdated and obsolete. However, long experience has taught us that many OAI contexts can still benefit from surgical management, constituting an essential complement to medical treatment. The present article seeks to contextualize this discussion by providing a chronological review of the surgical treatments used in cases of OAI and describing the quality of evidence supporting their rehabilitation in well-established situations.

摘要

在过去80年里,骨关节炎感染(OAIs)的治疗模式发生了巨大变化,从青霉素问世到使用广谱抗生素。在这些药物出现之前,手术是OAIs唯一可用的治疗方法;如今,抗生素治疗被认为是对它们的主要应对措施。因此,OAIs的手术治疗到目前为止很少被采用,有时甚至被认为过时和陈旧。然而,长期的经验告诉我们,许多OAIs情况仍可从手术管理中受益,这是药物治疗的重要补充。本文旨在通过按时间顺序回顾OAIs病例中使用的手术治疗方法,并描述在既定情况下支持其恢复的证据质量,来将这一讨论置于具体背景中。

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