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肩部手术后手术部位感染的局部抗生素持续灌注技术

Continuous local antibiotic perfusion technique for surgical site infections after shoulder surgery.

作者信息

Shimada Yohei, Ochiai Nobuyasu, Hashimoto Eiko, Kajiwara Daisuke, Hiraoka Yu, Inagaki Kenta, Ohtori Seiji, Niki Hisateru

机构信息

Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.

Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

JSES Rev Rep Tech. 2024 May 10;4(3):419-423. doi: 10.1016/j.xrrt.2024.04.013. eCollection 2024 Aug.

DOI:10.1016/j.xrrt.2024.04.013
PMID:39157251
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11329016/
Abstract

BACKGROUND

Continuous local antibiotic perfusion (CLAP) is a method for preserving tissue and function against surgical site infections (SSIs) after shoulder surgery.

METHODS

To describe the application of the novel CLAP technique to 10 patients with SSIs after shoulder surgery that were not controlled with repeated surgical débridement or elderly patients who are insufficient physical resilience for further surgeries.

RESULTS

CLAP, consisting of gentamicin, was performed for 2 weeks, after which the infection was well-controlled. The white blood cell count and C-reactive protein level improved rapidly within 1 week of initiating CLAP, after which the patients were switched to oral antibiotics for 3 months. None of the patients experienced any adverse events.

CONCLUSION

CLAP for SSIs after shoulder surgery was successful in preserving implants and grafts. The SSIs were controlled with no adverse events. CLAP may be an important treatment option for SSIs after shoulder surgery.

摘要

背景

持续局部抗生素灌注（CLAP）是一种在肩部手术后预防手术部位感染（SSIs）并保留组织和功能的方法。

方法

描述新型CLAP技术在10例肩部手术后发生手术部位感染且经反复手术清创仍无法控制感染的患者，或因身体恢复能力不足而无法进行进一步手术的老年患者中的应用。

结果

使用庆大霉素进行CLAP治疗2周后，感染得到良好控制。开始CLAP治疗后1周内白细胞计数和C反应蛋白水平迅速改善，之后患者改用口服抗生素治疗3个月。所有患者均未出现任何不良事件。

结论

肩部手术后手术部位感染采用CLAP治疗成功保留了植入物和移植物。手术部位感染得到控制且无不良事件发生。CLAP可能是肩部手术后手术部位感染的重要治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/eb871f2b702c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/63a4ea313284/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/15068c1e86c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/a3edd72bd478/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/eb871f2b702c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/63a4ea313284/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/15068c1e86c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/a3edd72bd478/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc92/11329016/eb871f2b702c/gr4.jpg

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本文引用的文献

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Continuous local antibiotic perfusion for patients with surgical site infection after instrumented spinal surgery; a novel technique to retain the implants.经器械辅助脊柱手术后手术部位感染患者的持续局部抗生素灌洗：一种保留植入物的新方法。
J Clin Neurosci. 2021 Nov;93:70-74. doi: 10.1016/j.jocn.2021.09.001. Epub 2021 Sep 13.
2
Intra-medullary antibiotics perfusion (iMAP) for the control of fracture-related infection early after osteosynthesis.髓内抗生素灌注（iMAP）在骨折内固定术后早期控制骨折相关感染。
J Orthop Surg (Hong Kong). 2021 Sep-Dec;29(3):23094990211051492. doi: 10.1177/23094990211051492.
3
A novel treatment strategy using continuous local antibiotic perfusion: A case series study of a refractory infection caused by hypervirulent Klebsiella pneumoniae.
一种新型的局部持续抗生素灌注治疗策略：产超毒力肺炎克雷伯菌难治性感染的病例系列研究。
J Orthop Sci. 2022 Jan;27(1):272-280. doi: 10.1016/j.jos.2020.11.010. Epub 2021 Jan 19.
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Biofilm formation and determination of minimum biofilm eradication concentration of antibiotics in Mycoplasma hyopneumoniae.猪肺炎支原体生物膜的形成及抗生素最低生物膜清除浓度的测定
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Susceptibility patterns of Staphylococcus aureus biofilms in diabetic foot infections.糖尿病足感染中金黄色葡萄球菌生物膜的药敏模式
BMC Microbiol. 2016 Jun 23;16(1):119. doi: 10.1186/s12866-016-0737-0.
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Clin Infect Dis. 2013 Jan;56(1):e1-e25. doi: 10.1093/cid/cis803. Epub 2012 Dec 6.
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Ann Rheum Dis. 2007 Apr;66(4):440-5. doi: 10.1136/ard.2006.058909. Epub 2007 Jan 12.
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Septic arthritis of the shoulder, elbow, and wrist.肩、肘和腕部的化脓性关节炎。
Clin Orthop Relat Res. 2006 Oct;451:42-5. doi: 10.1097/01.blo.0000229322.30169.29.
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Long Bone Osteomyelitis.长骨骨髓炎
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