Böhler M, Czasch W, Salzer M, Knahr K
Orthopädisches Spital Speising, Wien, II. Allgemein orthopädische Abteilung.
Z Orthop Ihre Grenzgeb. 1996 Mar-Apr;134(2):125-30. doi: 10.1055/s-2008-1039783.
41 draining sinuses after THR were treated by debridement without exchanging the implants. Positive bacterial cultures were obtained in 23 patients-the ilio tibial tract was found open in 19 cases (82%). The bacterial cultures were negative in 18 patients-the ilio tibial tract was found open in 7 cases (38%). Revisions took place 21 days (9-43) after primary implantation. At the time of the follow up (0 72 months postoperatively) 7 patients had been revised (8-97) because of recurrence of infection. The results of debridements of contaminated sinuses depend on the ilio tibial tract. Revisions were successful in three out of four paces with an intact, and only in eight out of nineteen cases with an open ilio tibial tract. Besides proper bacterial investigation preoperative sinograms give useful information about the prognosis of revision. In cases with positive bacterial cultures debridements should be done very early to eradicate infection without removing the implants.
41例全髋关节置换术后引流性窦道患者接受了清创术,未更换植入物。23例患者细菌培养呈阳性,其中19例(82%)发现髂胫束开放。18例患者细菌培养呈阴性,其中7例(38%)发现髂胫束开放。翻修手术在初次植入后21天(9 - 43天)进行。在随访时(术后0至72个月),7例患者(8至97个月)因感染复发而接受了翻修。污染性窦道的清创结果取决于髂胫束。在髂胫束完整的四例患者中有三例翻修成功,而在髂胫束开放的19例患者中只有八例成功。除了进行适当的细菌检测外,术前窦道造影可为翻修预后提供有用信息。对于细菌培养呈阳性的病例,应尽早进行清创以根除感染,而无需取出植入物。