用诱导膜技术治疗感染性骨缺损。

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING
Jie Shen, Zhiyuan Wei, Shulin Wang, Xiaohua Wang, Wei Lin, Lei Liu, Guanglin Wang
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引用次数: 0

摘要

目的:本研究旨在评估诱导膜技术治疗感染性骨缺损的有效性,并探讨可能影响患者预后的因素:方法:在 2000 年 1 月 1 日至 2021 年 10 月 31 日期间,在 PubMed、Embase 和 Cochrane Central Register of Controlled Trials 数据库中进行了全面检索。纳入的研究样本量至少为五名使用诱导膜技术治疗感染性骨缺损的患者。通过对患者个体数据进行逻辑回归分析,确定了与不愈合、感染复发和额外手术相关的因素:经过筛选,共有 44 项研究纳入了采用诱导膜技术治疗的 1,079 名患者和 1,083 个感染性骨缺损片段。平均缺损大小为 6.8 厘米(0.5 至 30 厘米)。在指数第二阶段手术后,85%(797/942)的节段实现了结合,92%(999/1,083)的节段实现了最终愈合。对296名患者的数据进行的多变量分析表明,年龄越大,不愈合的风险越高。在第二阶段进行外固定的患者发生骨不连的风险明显更高,因此需要进行更多手术。从股骨再植器-灌注器-吸引器中获取的自体移植物增加了非骨髁愈合、感染复发和额外手术的发生率:结论:诱导膜技术是治疗感染性骨缺损的有效技术。结论:诱导膜技术是治疗感染性骨缺损的有效技术,在第二阶段进行内固定可有效促进骨愈合,减少额外手术,同时不会增加感染复发率。未来的研究应该对患者的个体数据进行前瞻性标准化,以促进对受影响患者结果的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Treatment of infected bone defects with the induced membrane technique.

Treatment of infected bone defects with the induced membrane technique.

Aims: This study aimed to evaluate the effectiveness of the induced membrane technique for treating infected bone defects, and to explore the factors that might affect patient outcomes.

Methods: A comprehensive search was performed in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases between 1 January 2000 and 31 October 2021. Studies with a minimum sample size of five patients with infected bone defects treated with the induced membrane technique were included. Factors associated with nonunion, infection recurrence, and additional procedures were identified using logistic regression analysis on individual patient data.

Results: After the screening, 44 studies were included with 1,079 patients and 1,083 segments of infected bone defects treated with the induced membrane technique. The mean defect size was 6.8 cm (0.5 to 30). After the index second stage procedure, 85% (797/942) of segments achieved union, and 92% (999/1,083) of segments achieved final healing. The multivariate analysis with data from 296 patients suggested that older age was associated with higher nonunion risk. Patients with external fixation in the second stage had a significantly higher risk of developing nonunion, increasing the need for additional procedures. The autografts harvested from the femur reamer-irrigator-aspirator increased nonunion, infection recurrence, and additional procedure rates.

Conclusion: The induced membrane technique is an effective technique for treating infected bone defects. Internal fixation during the second stage might effectively promote bone healing and reduce additional procedures without increasing infection recurrence. Future studies should standardize individual patient data prospectively to facilitate research on the affected patient outcomes.

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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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