Mehmet Batu Ertan, Kerem Başarır, Hakan Kocaoğlu, Mehmet Yağız Ayduğan, Erdal Güngör
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引用次数: 0
Abstract
Background: Intraoperative irrigation with diluted povidone iodine (PI) can be used to reduce the incidence of infection-related complications in arthroplasty surgeries. Since PI is associated with many interventions, especially skin antisepsis, its systemic effects are being studied. The aim of our study is to evaluate the systemic effects of PI, which we use as an irrigation solution, by means of urine iodine and thyroid function tests.
Methods: In this case-control study, 96 patients who underwent knee or hip arthroplasty were included and divided into two groups according to the irrigation solution. In the first group, PI was added to the standard irrigation. The second group was considered as the control group and only standard irrigation was applied. Urine iodine, thyroid stimulating hormone, free T3 and free T4 values were compared in the preoperative and postoperative periods of these two groups. In this way, the effect of absorbed iodine on thyroid functions was investigated.
Results: In the diluted PI group, urinary iodine levels were measured at maximum levels (450 µg/L) in the early postoperative period in most of the patients. The statistically significant difference in urinary iodine levels between the PI group and the control group, which started in the early postoperative period, continued until the last follow-up on the 14th postoperative day. In terms of thyroid functions, the observed differences were not statistically significant.
Conclusion: Studies to reduce periprosthetic infection show that PI can be preferred for irrigation before the closure of the joint area in total joint arthroplasty. Although the success of this treatment in periprosthetic infection has been investigated, its systemic examination has not been demonstrated. It was determined that PI treatment, which was seen to decrease in the systemic circulation within 14 days, did not show a statistically significant change in terms of thyroid functions when used at the determined concentration and duration. These results should be evaluated with larger and longer-term studies.
Trial registration: Clinical trials ID no. NCT05599841.
背景：使用稀释的聚维酮碘（PI）进行术中冲洗可降低关节置换手术中感染相关并发症的发生率。由于 PI 与许多干预措施有关，尤其是皮肤防腐，因此正在对其全身影响进行研究。我们的研究旨在通过尿碘和甲状腺功能检测来评估 PI 的全身效应：在这项病例对照研究中，我们纳入了 96 名接受膝关节或髋关节置换术的患者，并根据冲洗液的不同分为两组。第一组在标准灌洗液中加入 PI。第二组为对照组，仅使用标准灌洗液。比较两组患者术前和术后的尿碘、促甲状腺激素、游离 T3 和游离 T4 值。通过这种方法，研究了吸收的碘对甲状腺功能的影响：结果：在稀释 PI 组中，大多数患者在术后早期测得的尿碘水平达到最高值（450 微克/升）。稀释 PI 组与对照组之间的尿碘水平差异从术后早期开始，一直持续到术后第 14 天的最后一次随访。在甲状腺功能方面，观察到的差异没有统计学意义：减少假体周围感染的研究表明，在全关节置换术中，在关闭关节区之前可首选 PI 进行灌洗。虽然已对该疗法在假体周围感染方面的成功进行了研究，但其系统性检查尚未得到证实。据测定，PI 治疗在 14 天内会在全身循环中减少，但以确定的浓度和持续时间使用时，甲状腺功能并没有出现统计学意义上的显著变化。这些结果应通过更大规模和更长期的研究进行评估：临床试验 ID 编号：NCT05599841。NCT05599841.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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