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感染性髋关节置换二期翻修术中术中血液回收的安全性

Safety of Intraoperative Cell Salvage in Two-Stage Revision of Septic Hip Arthroplasties.

作者信息

Krüger Lara, Strahl André, Goedecke Eva, Delsmann Maximilian M, Leonhardt Leon-Gordian, Beil Frank Timo, Hubert Jan

机构信息

Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.

出版信息

Antibiotics (Basel). 2024 Sep 21;13(9):902. doi: 10.3390/antibiotics13090902.

Abstract

(1) Background: The aim of this study was to evaluate the safety of intraoperative cell salvage (ICS) during reimplantation in the two-stage revision of septic hip arthroplasties. (2) Methods: As part of an internal quality control study, blood cultures were taken from the processed ICS blood during reimplantation and examined for possible bacterial load (study group). Due to a high rate of bacterial detection with uncertain clinical significance, consecutive ICS samples were also examined from patients undergoing aseptic revision hip arthroplasty (control group). Microbiological samples, patient and surgical characteristics and the follow-up data were analyzed retrospectively. (3) Results: 9 out of 12 (75%) patients in the study group and 5 out of 8 (63%) patients in the control group had positive ICS blood cultures. There was no significant difference between the groups ( = 0.642). The initial pathogens causing the periprosthetic joint infection (PJI) were not detected, but the bacterial spectrum resembled skin flora, with a high proportion of coagulase-negative staphylococci. No complications due to possible bloodstream-associated infections were observed. In summary, the detected pathogens were interpreted as contamination without clinical significance. (4) Conclusions: ICS in the context of reimplantation was considered a safe and recommendable procedure to optimize patient blood management.

摘要

(1) 背景:本研究旨在评估在感染性髋关节置换二期翻修再植入过程中术中自体血回输(ICS)的安全性。(2) 方法:作为一项内部质量控制研究的一部分,在再植入过程中从处理后的ICS血液中采集血培养样本,并检测可能的细菌载量(研究组)。由于细菌检出率高但临床意义不确定,还对接受无菌翻修髋关节置换术的患者的连续ICS样本进行了检测(对照组)。对微生物样本、患者及手术特征以及随访数据进行回顾性分析。(3) 结果:研究组12例患者中有9例(75%)ICS血培养呈阳性,对照组8例患者中有5例(63%)呈阳性。两组之间无显著差异(P = 0.642)。未检测到引起假体周围关节感染(PJI)的初始病原体,但细菌谱类似于皮肤菌群,凝固酶阴性葡萄球菌比例较高。未观察到因可能的血流相关感染导致的并发症。总之,检测到的病原体被解释为无临床意义的污染。(4) 结论:在再植入情况下,ICS被认为是优化患者血液管理的一种安全且值得推荐的方法。

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