[1]莫生福,黄大波,韦仁杰,等.抗生素骨水泥覆盖治疗慢性难愈性创面30例[J].中国中医骨伤科杂志,2024,32(06):85-89.[doi:10.20085/j.cnki.issn1005-0205.240617]
　MO Shengfu,HUANG Dabo,WEI Renjie,et al.Report of 30 Cases of Antibiotic-Loaded Bone Cement Coverage for the Treatment of Chronic Refractory Wounds[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(06):85-89.[doi:10.20085/j.cnki.issn1005-0205.240617]
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抗生素骨水泥覆盖治疗慢性难愈性创面30例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年06期
页码:
85-89
栏目:
临床报道
出版日期:
2024-06-15

文章信息/Info

Title:
Report of 30 Cases of Antibiotic-Loaded Bone Cement Coverage for the Treatment of Chronic Refractory Wounds
文章编号:
1005-0205(2024)06-0085-05
作者:
莫生福1; 黄大波1; 韦仁杰1; 韦杰合1
1河池市人民医院(广西 河池,546300)
Author(s):
MO Shengfu1; HUANG Dabo1; WEI Renjie1; WEI Jiehe1
1Hechi People's Hospital,Hechi 546300,Guangxi China.
关键词:
抗生素骨水泥;  慢性难愈性创面;  感染;  利福平;  万古霉素
Keywords:
antibiotic-loaded bone cement;  chronic refractory wounds;  infection;  rifampicin;  vancomycin
分类号:
R681
DOI:
10.20085/j.cnki.issn1005-0205.240617
文献标志码:
B
摘要:
目的:观察抗生素骨水泥覆盖治疗慢性难愈合创面的疗效。方法:选择2020年1月至2023年1月收治的30例慢性难愈性创面患者,给予抗生素骨水泥覆盖治疗,并对疗效进行评价。结果:30例患者最终治愈21例(70.00%),有效7例(23.30%),无效2例(6.67%),总有效率为93.30%。平均清创次数为(1.63±1.13)次,术前及术后3周白细胞计数、C反应蛋白、红细胞沉降率比较差异均有统计学意义(P<0.05)。结论:抗生素骨水泥覆盖治疗慢性难愈性创面疗效确切,能控制创面感染,治疗效果令人满意。
Abstract:
Objective:To investigate the efficacy of treatment of chronic refractory wounds with antibiotic-loaded bone cement coverage.Methods:30 patients with chronic refractory wounds between January 2020 and January 2023 who were treated with antibiotic-loaded bone cement therapy were selected for the study to evaluate its efficacy.Results:The final cure rate of the 30 patients included in the study was 21(70.00%),7(23.30%)effective and 2(6.67%)ineffective,that is,the overall efficacy was 93.30%.The mean number of debridements was(1.63±1.13)times,and there were differences in leukocyte count,C-reactive protein and erythrocyte sedimentation rate before surgery and 3 weeks after surgery(P<0.05).Conclusion:The efficacy of antibiotic-loaded bone cement coverage in the treatment of chronic refractory wounds is accurate,provides effective control of wound infection and has a satisfactory therapeutic effect.

参考文献/References:

[1] LIU J,SHEN H.Clinical efficacy of chitosan-based hydrocolloid dressing in the treatment of chronic refractory wounds[J].Int Wound J,2022,19(8):2012-2018.
[2] SEN C K.Human wound and its burden:updated 2020 compendium of estimates[J].Adv Wound Care(New Rochelle),2021,10(5):281-292.
[3] 余墨声,朱占永,赵月强,等.慢性创面的临床治疗进展[J].临床外科杂志,2016,24(3):165-167.
[4] SIBBALD R G,ELLIOTT J A,PERSAUD-JAIMANGAL R,et al.Wound bed preparation 2021[J].Adv Skin Wound Care,2021,34(4):183-195.
[5] SCHILRREFF P,ALEXIEV U.Chronic inflammation in non-healing skin wounds and promising natural bioactive compounds treatment[J].Int J Mol Sci,2022,23(9):4928.
[6] METSEMAKERS W J,FRAGOMEN A T,MORIARTY T F,et al.Fracture-related infection(FRI)consensus group:evidence-based recommendations for local antimicrobial strategies and dead space management in fracture-related infection[J].J Orthop Trauma,2020,34(1):18-29.
[7] DONG T,HUANG Q,SUN Z.Antibiotic-loaded bone cement for diabetic foot infected wounds:a systematic review and meta-analysis[J].Front Endocrinol(Lausanne),2023,14:1134318.
[8] WANG L,LU S,LUO W,et al.Efficacy comparison of antibiotic bone cement-coated implants and external fixations for treating infected bone defects[J].Int Orthop,2023,47(5):1171-1179.
[9] 许飞,许志俊,廖文强,等.慢性难愈性创面的治疗研究进展[J].江西医药,2020,55(3):354-358.
[10] 廖新成,郭光华.慢性难愈性创面的分类鉴别及临床评估[J].中华损伤与修复杂志(电子版),2017,12(4):303-305.
[11] RAZIYEVA K,KIM Y,ZHARKINBEKOV Z,et al.Immunology of acute and chronic wound healing[J].Biomolecules,2021,11(5):700.
[12] 马莉,张金东,张家雯,等.仁宝生肌膏联合红/蓝光治疗慢性难愈合创面的疗效[J].中国中医骨伤科杂志,2022,30(10):28-32.
[13] DONG X M,PEI L L,LU P S,et al.Bacteriological investigation and drug resistance analysis of chronic refractory wound secretions[J].J Craniofac Surg,2022,33(7):2028-2030.
[14] 邓雪.不同浓度自体富血小板血浆治疗慢性难愈性创面的临床效果研究[J].中国全科医学,2021,24(S2):62-64.
[15] 王倩,冯颖,祝红娟.自体富血小板血浆凝胶在创面修复中的应用研究进展[J].中国研究型医院,2022,9(2):61-64.
[16] FALCONE M,DE ANGELIS B,PEA F,et al.Challenges in the management of chronic wound infections[J].J Glob Antimicrob Resist,2021,26:140-147.
[17] 郭文闻,黄金梅,唐乾利.慢性难愈合创面治疗的研究进展[J].中国烧伤创疡杂志,2023,35(2):89-92.
[18] PIWNICA-WORMS W,AZOURY S C,KOZAK G,et al.Flap reconstruction for deep sternal wound infections:factors influencing morbidity and mortality[J].Ann Thorac Surg,2020,109(5):1584-1590.
[19] GANDHI R,BACKSTEIN D,ZYWIEL M G.Antibiotic-laden bone cement in primary and revision hip and knee arthroplasty[J].J Am Acad Orthop Surg,2018,26(20):727-734.
[20] 程后庆,张永,刘刚,等.抗生素骨水泥表面置四肢感染创面治疗中的应用[J].中国中医骨伤科杂志,2023,31(9):50-53.
[21] CHEN I C,SU C Y,NIEN W H,et al.Influence of antibiotic-loaded acrylic bone cement composition on drug release behavior and mechanism[J].Polymers(Basel),2021,13(14):2240.
[22] WU M,PAN H,LENG W,et al.Distribution of microbes and drug susceptibility in patients with diabetic foot infections in southwest China[J].J Diabetes Res,2018,2018:9817308.
[23] QIAO Z,YUAN Z,ZHANG W,et al.Preparation,in vitro release and antibacterial activity evaluation of rifampicin and moxifloxacin-loaded poly(D,L-lactide-co-glycolide)microspheres[J].Artif Cells Nanomed Biotechnol,2019,47(1):790-798.
[24] GRUBER H E,ODE G,HOELSCHER G,et al.Osteogenic,stem cell and molecular characterisation of the human induced membrane from extremity bone defects[J].Bone Joint Res,2016,5(4):106-115.
[25] ALFORD A I,NICOLAOU D,HAKE M,et al.Masquelet's induced membrane technique:review of current concepts and future directions[J].J Orthop Res,2021,39(4):707-718.
[26] MCBRIDE-GAGYI S,TOTH Z,KIM D,et al.Altering spacer material affects bone regeneration in the Masquelet technique in a rat femoral defect[J].J Orthop Res,2018,36(8):2228-2238.
[27] LIU C,YOU J X,CHEN Y X,et al.Effect of induced membrane formation followed by polymethyl methacrylate implantation on diabetic foot ulcer healing when revascularization is not feasible[J].J Diabetes Res,2019:2429136.
[28] CAI L,HONG Z,ZHANG Y,et al.Management of wounds with exposed bone structures using an induced-membrane followed by polymethyl methacrylate and second-stage skin grafting in the elderly with a 3-year follow-up[J].Int Wound J,2023,20(4):1020-1032.
[29] NEUT D,VAN DE BELT H,STOKROOS I,et al.Biomaterial-associated infection of gentamicin-loaded PMMA beads in orthopaedic revision surgery[J].J Antimicrob Chemother,2001,47(6):885-891.
[30] JIN F,XIE Y,WANG N,et al.Poor osteoinductive potential of subcutaneous bone cement-induced membranes for tissue engineered bone[J].Connect Tissue Res,2013,54(4/5):283-289.
[31] MASQUELET A C.Induced membrane technique:pearls and pitfalls[J].J Orthop Trauma,2017,31(Suppl 5):S36-S38.

更新日期/Last Update: 2024-06-15