PDF(Pubmed)
Abstract：
UNASSIGNED: This study has investigated cases of pin site infection (PSI) which required surgery for persistent osteomyelitis (OM) despite pin removal.
UNASSIGNED: Patients requiring surgery for OM after PSI between 2011 and 2021 were included in this retrospective cohort study. Single-stage surgery was performed in accordance with a protocol at one institution. This involved deep sampling, debridement, implantation of local antibiotics, culture-specific systemic antibiotics and soft tissue closure. A successful outcome was defined as an infection-free interval of at least 24 months following surgery.
UNASSIGNED: Twenty-seven patients were identified (the sites were 22 tibias, 2 humeri, 2 calcanei, 1 radius); about 85% of them were males with a median age of 53.9 years. The majority of infections (21/27) followed fracture treatment. Fifteen patients were classified as BACH uncomplicated and 12 were BACH complex. Staphylococci were the most common pathogens, polymicrobial infections were detected in five cases (19%). Seven patients required flap coverage which was performed in the same operation.After a median of 3.99 years (2.00-8.05) follow-up, all patients remained infection free at the site of the former OM. Wound leakage after local antibiotic treatment was seen in 3/27 (11.1%) cases but did not require further treatment.
UNASSIGNED: Osteomyelitis after PSI is uncommon but has major implications for the patient as 7 patients needed flap coverage. This reinforces the need for careful pin placement and pin site care to prevent deep infection. These infections were treated in accordance with a protocol and were not managed simply by curettage. All patients treated in this manner remained infection-free after a minimum follow-up of 2 years suggesting that this protocol is effective.
UNASSIGNED: Pin site infection is a very common complication in external fixation. The sequela of a chronic pin site OM is rare but the implications to the patient are huge. In this series, more than a quarter of patients required flap coverage as part of the treatment of the deep infection.
UNASSIGNED: Frank FA, Pomeroy E, Hotchen AJ, et al. Clinical Outcome following Management of Severe Osteomyelitis due to Pin Site Infection. Strategies Trauma Limb Reconstr 2024;19(1):21-25.
UNASSIGNED: Patients requiring surgery for OM after PSI between 2011 and 2021 were included in this retrospective cohort study. Single-stage surgery was performed in accordance with a protocol at one institution. This involved deep sampling, debridement, implantation of local antibiotics, culture-specific systemic antibiotics and soft tissue closure. A successful outcome was defined as an infection-free interval of at least 24 months following surgery.
UNASSIGNED: Twenty-seven patients were identified (the sites were 22 tibias, 2 humeri, 2 calcanei, 1 radius); about 85% of them were males with a median age of 53.9 years. The majority of infections (21/27) followed fracture treatment. Fifteen patients were classified as BACH uncomplicated and 12 were BACH complex. Staphylococci were the most common pathogens, polymicrobial infections were detected in five cases (19%). Seven patients required flap coverage which was performed in the same operation.After a median of 3.99 years (2.00-8.05) follow-up, all patients remained infection free at the site of the former OM. Wound leakage after local antibiotic treatment was seen in 3/27 (11.1%) cases but did not require further treatment.
UNASSIGNED: Osteomyelitis after PSI is uncommon but has major implications for the patient as 7 patients needed flap coverage. This reinforces the need for careful pin placement and pin site care to prevent deep infection. These infections were treated in accordance with a protocol and were not managed simply by curettage. All patients treated in this manner remained infection-free after a minimum follow-up of 2 years suggesting that this protocol is effective.
UNASSIGNED: Pin site infection is a very common complication in external fixation. The sequela of a chronic pin site OM is rare but the implications to the patient are huge. In this series, more than a quarter of patients required flap coverage as part of the treatment of the deep infection.
UNASSIGNED: Frank FA, Pomeroy E, Hotchen AJ, et al. Clinical Outcome following Management of Severe Osteomyelitis due to Pin Site Infection. Strategies Trauma Limb Reconstr 2024;19(1):21-25.
摘要：
■本研究调查了针部位感染（PSI）的病例，尽管拔除了针，但仍需要手术治疗持续性骨髓炎（OM）。
■本回顾性队列研究包括2011年至2021年PSI后需要进行OM手术的患者。在一个机构中根据方案进行单阶段手术。这涉及深度采样，清创术,植入局部抗生素，培养特异性全身抗生素和软组织闭合。成功的结果定义为手术后至少24个月的无感染间隔。
■确定了27名患者（这些部位是22个胫骨，2humeri,2calcanei，1半径）；其中约85％为男性，中位年龄为53.9岁。大多数感染（21/27）发生在骨折治疗之后。15例患者被分类为无并发症的BACH，12例为BACH复合物。葡萄球菌是最常见的病原体，在5例（19％）中检测到多微生物感染。七名患者需要在同一手术中进行的皮瓣覆盖。经过3.99年（2.00-8.05）的中位随访，所有患者在前OM部位保持无感染。局部抗生素治疗后的伤口渗漏在3/27（11.1％）病例中可见，但不需要进一步治疗。
■PSI后骨髓炎并不常见，但对患者有重大影响，因为7例患者需要皮瓣覆盖。这加强了仔细放置销和销部位护理以防止深部感染的需要。这些感染根据方案进行治疗，而不是简单地通过刮宫进行治疗。以这种方式治疗的所有患者在最少2年的随访后保持无感染,表明该方案是有效的。
■销部位感染是外固定中非常常见的并发症。慢性pin位点OM的后遗症很少见，但对患者的影响是巨大的。在这个系列中,超过四分之一的患者需要覆盖皮瓣作为深部感染治疗的一部分.
■弗兰克·FA，PomeroyE,HotchenAJ,etal.销部位感染引起的严重骨髓炎治疗后的临床结果。创伤肢体重建策略2024；19(1)：21-25。
■本回顾性队列研究包括2011年至2021年PSI后需要进行OM手术的患者。在一个机构中根据方案进行单阶段手术。这涉及深度采样，清创术,植入局部抗生素，培养特异性全身抗生素和软组织闭合。成功的结果定义为手术后至少24个月的无感染间隔。
■确定了27名患者（这些部位是22个胫骨，2humeri,2calcanei，1半径）；其中约85％为男性，中位年龄为53.9岁。大多数感染（21/27）发生在骨折治疗之后。15例患者被分类为无并发症的BACH，12例为BACH复合物。葡萄球菌是最常见的病原体，在5例（19％）中检测到多微生物感染。七名患者需要在同一手术中进行的皮瓣覆盖。经过3.99年（2.00-8.05）的中位随访，所有患者在前OM部位保持无感染。局部抗生素治疗后的伤口渗漏在3/27（11.1％）病例中可见，但不需要进一步治疗。
■PSI后骨髓炎并不常见，但对患者有重大影响，因为7例患者需要皮瓣覆盖。这加强了仔细放置销和销部位护理以防止深部感染的需要。这些感染根据方案进行治疗，而不是简单地通过刮宫进行治疗。以这种方式治疗的所有患者在最少2年的随访后保持无感染,表明该方案是有效的。
■销部位感染是外固定中非常常见的并发症。慢性pin位点OM的后遗症很少见，但对患者的影响是巨大的。在这个系列中,超过四分之一的患者需要覆盖皮瓣作为深部感染治疗的一部分.
■弗兰克·FA，PomeroyE,HotchenAJ,etal.销部位感染引起的严重骨髓炎治疗后的临床结果。创伤肢体重建策略2024；19(1)：21-25。
