[Clinical evolution of patients with infection associated with orthopedic devices in treatment with continuous negative pressure].

Jorge Quiroz-Williams, José R Viveros-Encarnación, Suemmy Gaytán-Fernández, Rodolfo G Barragán-Hervella, Carlos R Rueda-Alvarado, América Ramírez-Polanco, M Paloma Martínez-Senda, Andrea M Palma-Jaimes
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引用次数: 0

Abstract

Objective: To describe the use of negative pressure therapy with (TPNi) and without instillation (TPNs) as adjuvant treatment in the management of orthopedic device-associated infections (IADO).

Method: Analytic observational study of records of patients with IADO managed with TPNi and TPNs with 0.9% saline solution, in patients > 18 years, operated on in 2018-2021. Clinical characteristics of infection, infectious agent as well as sociodemographic variables were evaluated. TPN was performed with the V.A.C. VERAFLO™ system. Analysis with χ2, Fisher and t-Student. Statistically accepted value p < 0.05.

Results: Sample 40 patients. 75% male. Fractures 42.5% exposed and 57.5% closed. 92.5% applied prophylactic antibiotic (30-120 min). 35% plate implants, 12.5% centromedullary nail, 10% knee prosthesis and 12.5% hip. 47.5% bleeding < 500 ml. 72.5% surgical time of 2-4 hours. Previous hospitalization time, TPNs 3 weeks 55.9% and 4 weeks 26.5%; TPNi, 3 weeks 50% and 4 weeks 33.3%. Conservation of the implant 73.5% TPNs and 50% TPNi (p = 0.341). Wound closure 91.2% with TPNs and 100% with TPNi (p = 1.000).

Conclusions: The use of TPNs and TPNi were useful as adjuvant treatments in the management of IADO, in addition they allowed to preserve the implant and wound closure in a large part of the patients.

[持续负压治疗骨科设备相关感染患者的临床演变]。
目的描述在骨科器械相关感染(IADO)治疗中使用负压疗法(TPNi)和不灌注负压疗法(TPNs)作为辅助治疗的情况:对2018-2021年手术的18岁以上IADO患者使用TPNi和0.9%生理盐水TPNs治疗的记录进行分析观察研究。对感染的临床特征、感染病原体以及社会人口学变量进行了评估。TPN使用V.A.C. VERAFLO™系统进行。用χ2、费雪和 t-Student 进行分析。统计学接受值 p < 0.05:样本 40 名患者。男性占 75%。42.5%的骨折为暴露骨折,57.5%为闭合骨折。92.5%应用预防性抗生素(30-120 分钟)。35%植入钢板,12.5%植入髓内钉,10%植入膝关节假体,12.5%植入髋关节假体。47.5%出血量小于 500 毫升。72.5%的手术时间为2-4小时。之前的住院时间,TPNs 3周55.9%,4周26.5%;TPNi,3周50%,4周33.3%。植入物的保存率:73.5%为TPNs,50%为TPNi(P = 0.341)。使用 TPNs 的伤口闭合率为 91.2%,使用 TPNi 的伤口闭合率为 100%(p = 1.000):使用 TPNs 和 TPNi 作为 IADO 的辅助治疗方法非常有用,此外,它们还能保留植入物,并使大部分患者的伤口闭合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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