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小动物骨合成术后植入物的微生物定植:发生率及影响因素

Microbial Colonization of Explants after Osteosynthesis in Small Animals: Incidence and Influencing Factors.

作者信息

Candela Andrade Mario, Slunsky Pavel, Pagel Tanja, De Rus Aznar Ignacio, Brunnberg Mathias, Brunnberg Leo

机构信息

Department of Medicine, Health and Medical University, 14471 Potsdam, Germany.

Small Animal Hospital, Anicura Kleintierspezialisten Augsburg, 86157 Augsburg, Germany.

出版信息

Vet Sci. 2024 May 16;11(5):221. doi: 10.3390/vetsci11050221.

Abstract

Despite recent advancements in antibiotics, hygienic measures, and peri-operative systemic antibiotics, post-operative infections in osteosynthesis remain prevalent and continue to be among the most common surgical complications, leading to delayed fracture healing, osteomyelitis, implant loosening, and loss of function. Osteosynthesis implants are routinely utilized in veterinary medicine and the current study investigates the microbial colonization of implants following osteosynthesis in small animals, along with its incidence and influencing factors. The results are analyzed in regard to correlations between infection, patient, disease progression, and radiographic images, as well as other factors that may promote infection. Seventy-one explants from sixty-five patients were examined and evaluated for microbial colonization. Factors like body weight and age, location and type of plate and additional injuries like lung lesions, the surgeon's experience, or the number of people present during the surgical procedure seem to influence the development of an infection. Of the animals, 60% showed osteolytic changes and 73.3% of those with dysfunctional mobility had an implant infection. Microorganisms were detected in almost 50% of the explants, but a clinically relevant infection was only present in five patients (7.3%), suggesting that the presence of microorganisms on an implant does not necessarily lead to treatment complications.

摘要

尽管近年来在抗生素、卫生措施和围手术期全身使用抗生素方面取得了进展,但骨接合术后感染仍然普遍存在,并且仍然是最常见的手术并发症之一,会导致骨折愈合延迟、骨髓炎、植入物松动和功能丧失。骨接合植入物在兽医学中经常使用,当前的研究调查了小动物骨接合术后植入物的微生物定植情况,以及其发生率和影响因素。分析了感染、患者、疾病进展和X光影像之间的相关性结果,以及其他可能促进感染的因素。对来自65例患者的71个外植体进行了微生物定植检查和评估。体重和年龄、钢板的位置和类型以及肺部损伤等其他损伤、外科医生的经验或手术过程中的在场人数等因素似乎会影响感染的发生。在这些动物中,60%出现了骨质溶解变化,在那些活动功能失调的动物中,73.3%发生了植入物感染。在近50%的外植体中检测到了微生物,但只有5例患者(7.3%)出现了临床相关感染,这表明植入物上存在微生物不一定会导致治疗并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4066/11125892/c86199dc1333/vetsci-11-00221-g001.jpg

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