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抗生素珠袋——创伤手术中用于临时软组织覆盖、预防感染和治疗的一项有用技术。

The antibiotic bead pouch - a useful technique for temporary soft tissue coverage, infection prevention and therapy in trauma surgery.

作者信息

Rupp Markus, Walter Nike, Szymski Dominik, Taeger Christian, Langer Martin Franz, Alt Volker

机构信息

Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.

Plastische Chirurgie & Ästhetik an der Isar, Widenmayerstraße 16, 80538 Munich, Germany.

出版信息

J Bone Jt Infect. 2023 Jun 21;8(3):165-173. doi: 10.5194/jbji-8-165-2023. eCollection 2023.

Abstract

Soft tissue defects resulting from trauma and musculoskeletal infections can complicate surgical treatment. Appropriate temporary coverage of these defects is essential to achieve the best outcomes for necessary plastic soft tissue defect reconstruction. The antibiotic bead pouch technique is a reasonable surgical approach for managing temporary soft tissue defects following adequate surgical debridement. This technique involves the use of small diameter antibiotic-loaded bone cement beads to fill the dead space created by debridement. By applying antibiotics to the bone cement and covering the beads with an artificial skin graft, high local dosages of antibiotics can be achieved, resulting in the creation of a sterile wound that offers the best starting position for soft tissue and bone defect reconstruction. This narrative review describes the rationale for using this technique, including its advantages and disadvantages, as well as pearls and pitfalls associated with its use in daily practice. In addition, the article provides a comprehensive overview of the literature that has been published since the technique was introduced in surgical practice.

摘要

创伤和肌肉骨骼感染导致的软组织缺损会使手术治疗变得复杂。对这些缺损进行适当的临时覆盖对于必要的整形软组织缺损重建取得最佳效果至关重要。抗生素珠袋技术是在充分手术清创后处理临时软组织缺损的一种合理手术方法。该技术涉及使用小直径的载抗生素骨水泥珠来填充清创后形成的死腔。通过将抗生素应用于骨水泥并用人工皮肤移植物覆盖珠子,可以实现高局部剂量的抗生素,从而形成一个无菌伤口,为软组织和骨缺损重建提供最佳的起始位置。这篇叙述性综述描述了使用该技术的原理,包括其优缺点,以及在日常实践中使用该技术相关的技巧和陷阱。此外,本文还全面概述了自该技术引入外科实践以来已发表的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c824/10561378/84011066f298/jbji-8-165-f01.jpg

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