Sigmund Irene K, Ferry Tristan, Sousa Ricardo, Soriano Alex, Metsemakers Willem-Jan, Clauss Martin, Trebse Rihard, Wouthuyzen-Bakker Marjan
Department of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria.
Infectious and Tropical Diseases Unit, Croix-Rousse Hospital, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
J Bone Jt Infect. 2025 Apr 1;10(2):101-138. doi: 10.5194/jbji-10-101-2025. eCollection 2025.
It has been shown that the outcome of a DAIR (debridement, antimicrobial therapy, and implant retention) procedure depends on multiple factors (e.g. infection type, host factors, clinical presentation, condition of surrounding soft tissue, causing pathogen, surgical technique, antimicrobial therapy); therefore, adequate patient selection is key for DAIR success. In this position paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors for a DAIR procedure based on the most robust and most recently published data. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure. This position paper may help reduce reinfection rates as well as the physical, psychological, and economic burden associated with periprosthetic joint infection (PJI). We believe that a reasonable outcome can be achieved with careful patient selection, a dedicated multidisciplinary team, and an appropriate surgical technique and antimicrobial therapy.
已表明清创、抗菌治疗和植入物保留（DAIR）手术的结果取决于多种因素（如感染类型、宿主因素、临床表现、周围软组织状况、致病病原体、手术技术、抗菌治疗）；因此，恰当的患者选择是DAIR手术成功的关键。在本立场文件中，我们讨论影响结果的最相关因素，并根据最可靠和最新发表的数据确定DAIR手术的适应证、禁忌证和危险因素。此外，我们讨论了接受DAIR手术患者的手术技术与全身抗菌治疗相结合的情况。本立场文件可能有助于降低再感染率以及与假体周围关节感染（PJI）相关的身体、心理和经济负担。我们相信，通过仔细的患者选择、专业的多学科团队以及适当的手术技术和抗菌治疗，可以取得合理的结果。
