Irrigation and Debridement in the Management of Prosthetic Joint Infection: Traditional Indications Revisited
Irrigation and Debridement in the Management of Prosthetic Joint Infection: Traditional Indications Revisited
复制标题
DOI：
10.1016/j.arth.2010.01.104
复制
发表时间：
2010-10-01
影响因子：
3.5
通讯作者：
Parvizi, Javad
中科院分区：
文献类型：
--
作者：
Azzam, Khalid A.;Seeley, Mark;Parvizi, Javad
冲洗和清创术（I和D）是一种常用于治疗急性假体周围感染的手术。本研究回顾性分析了1997年至2005年在一家机构接受I和D并保留假体的髋关节或膝关节假体周围感染患者的临床记录。确定了104例患者（44例男性和60例女性）。初次清创时的平均年龄为65岁。平均随访5.7年。治疗失败被定义为需要切除关节成形术或复发性微生物学证实的感染。根据这些标准，I和D在46例患者（44%）中成功。葡萄球菌感染、美国麻醉医师协会评分升高和假体周围化脓的患者更容易失败。该手术的高失败率意味着它应该优选地限于选择具有低毒力微生物和可疑术中发现的健康患者。
Irrigation and debridement (I and D) is a procedure commonly used for the treatment of acute periprosthetic infection. This study retrospectively reviewed clinical records of patients with periprosthetic infection of the hip or knee who underwent I and D with retention of their prostheses between 1997 and 2005 at a single institution. One hundred four patients (44 males and 60 females) were identified. Mean age at time of initial debridement was 65 years. Average follow-up was 5.7 years. Treatment failure was defined as the need for resection arthroplasty or recurrent microbiologically proven infection. According to these criteria, I and D was successful in 46 patients (44%). Patients with staphylococcal infection, elevated American Society of Anesthesiologists score, and purulence around the prosthesis were more likely to fail. The high failure rate of this procedure implies that it should be preferably limited to select healthy patients with low virulence organisms and equivocal intraoperative findings.