假体周围关节感染(PJI)是全髋关节和膝关节置换术中的破坏性并发症。预防是降低发病率和避免一些严重影响患者和卫生系统的后果的关键。鉴于各种建议和准则,我们决定聘请专家,同行评审的欧洲共识分析,intra-,术后预防PJI。一个跨国骨科执业专家小组在6个主要干预组中制定了一系列47个共识声明,和一个2阶段的德尔福方法推出了协议的阈值在75%和非常高的协议在90%以上。总共收集了来自9个国家的306名整形外科医生的回复。就42/47项声明达成共识,第31/47号决议达成了非常高的共识。许多术前行动聚集了强烈的共识,尽管使用含酒精的氯己定或脱毛时机等领域并未达成强烈共识,尽管有证据。手术前后的动作表现出更多的可变性,皮肤缝合技术,和伤口随访。这项研究证实了欧洲整形外科医生在许多众所周知的有助于预防PJI的地区达成的重要共识;然而,仍有改进的理由。
Periprosthetic joint infection (PJI) is a devastating complication in total hip and knee replacement. Its prevention is key to decrease the incidence and avoid some consequences that seriously impact patients and health systems. In view of the variety of recommendations and
guidelines, we decided to conduct an expert, peer-reviewed European
consensus analysis about the pre-, intra-, and postoperative prevention of PJI. A multinational group of practicing orthopedic experts developed a series of 47
consensus statements in 6 main groups of intervention, and a 2-stage Delphi approach was launched with a threshold for agreement at 75% and for very high agreement at more than 90%. A total of 306 orthopedic surgeon responses were gathered from 9 countries.
Consensus was reached for 42/47 statements, 31/47 of which achieved a very high
consensus. Many preoperative actions gathered strong consensus, although areas like the use of alcoholic chlorhexidine or the timing of hair removal did not attain strong
consensus, despite available evidence. Intra- and postoperative actions showed more variability regarding incise drapes, skin suturing techniques, and wound follow-up. This study confirms an important consensus among orthopedic surgeons across Europe in many areas well known to contribute to the prevention of PJI; however, there are still grounds for improvement.