中国组织工程研究2016，Vol.20Issue(44)：6549-6556,8.DOI:10.3969/j.issn.2095-4344.2016.44.002
负压封闭式引流联合碘伏灌洗治疗人工关节置换后假体感染
Vacuum sealing drainage combined with iodophor douche for the prosthesis infection after artificial joint replacement
张阳春 1肖建红 2张紫机 3杨兴 4余世明 1盛璞义1
作者信息
- 1. 中山大学附属第一医院东院下肢骨科，广东省广州市 510700
- 2. 中山大学附属第一医院东院骨科研究所，广东省广州市 510000
- 3. 中山大学附属第一医院东院普内科，广东省广州市 510700
- 4. 中山大学附属第一医院 本部 关节外科，广东省广州市 510080
- 折叠
摘要
Abstract
BACKGROUND:Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE:To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS:Nine cases (six knees and three hips) of infection after artificial joint replacement were col ected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. Al patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. Al patients were regularly fol owed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement. RESULTS AND CONCLUSION:(1) Except that one case was stil in treatment, one case was dead, and one case of tumor prosthesis was failure and final y amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. Al healed patients were fol owed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement.关键词
骨科植入物/人工假体/负压式封闭引流/碘伏/人工关节置换/假体感染分类
医药卫生引用本文复制引用
张阳春,肖建红,张紫机,杨兴,余世明,盛璞义..负压封闭式引流联合碘伏灌洗治疗人工关节置换后假体感染[J].中国组织工程研究,2016,20(44):6549-6556,8.
