Department for Trauma Surgery, University Hospital Regensburg, Franz- Josef-Strauß-Allee 11, Regensburg, 93053, Germany.
Department for Trauma Surgery, University Hospital Regensburg, Franz- Josef-Strauß-Allee 11, Regensburg, 93053, Germany.
Injury. 2024 Nov;55 Suppl 6:111902. doi: 10.1016/j.injury.2024.111902.
Fracture-related infections (FRIs) are complex challenges in orthopedic and trauma surgery, driving ongoing advancements in diagnostics, therapeutics, and management strategies. This scoping review examines recent progress and future directions in FRI management. Diagnostic enhancements encompass standardized definitions, improved biomarkers, advanced microbiological techniques, and innovative imaging modalities. Promising future diagnostics may include point-of-care testing, advanced imaging with enhanced specificity, and machine learning algorithms. Advancements in implant technology emphasize materials science, surface modifications, and personalized 3D printing, enhancing durability and antimicrobial efficacy. Immunomodulatory therapies targeting T cell dysfunction offer potential in addressing FRI chronicity. Enzybiotics and phages present promising alternatives to combat antibiotic resistance, with enzybiotics demonstrating effectiveness against biofilm-associated infections. Patient optimization, multidisciplinary approaches and specialized reference centers play vital roles in comprehensive FRI management, particularly crucial in resource-constrained settings. Collaboration and investment in research and technology are imperative for harnessing the full potential of these advancements and improving global FRI management outcomes. Addressing these complexities necessitates a multifaceted approach integrating clinical expertise, technological innovation, and global cooperation to optimize patient care and mitigate the burden of FRI worldwide.
骨折相关感染(FRIs)是骨科和创伤外科面临的复杂挑战,推动了诊断、治疗和管理策略的不断进步。本范围综述探讨了 FRIs 管理方面的最新进展和未来方向。诊断方面的进展包括标准化定义、改进的生物标志物、先进的微生物学技术和创新的成像方式。有前途的未来诊断方法可能包括即时检测、具有更高特异性的先进成像和机器学习算法。植入物技术的进步强调了材料科学、表面改性和个性化 3D 打印,提高了耐用性和抗菌效果。针对 T 细胞功能障碍的免疫调节疗法为解决 FRIs 的慢性问题提供了潜力。酶原和噬菌体为对抗抗生素耐药性提供了有前途的替代方法,酶原对生物膜相关感染具有有效性。患者优化、多学科方法和专门的参考中心在综合 FRIs 管理中发挥着重要作用,特别是在资源有限的环境中至关重要。合作和投资于研究和技术对于充分利用这些进展和改善全球 FRIs 管理结果至关重要。解决这些复杂性需要采取多方面的方法,整合临床专业知识、技术创新和全球合作,以优化患者护理并减轻全球 FRIs 的负担。