Practical recommendations concerning diagnostics of implant-associated infection in the course of endoprosthetics of large joints under modern conditions

Николаев, Н. С.; Borisova, L.V.; Pchelova, N.N.; Orlova, A.V.; Karalin, A.N.

doi:10.21145/2499-9954-2016-3-40-45

Cited by 2 publications

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“…Однако реальная практика показывает следующее: несмотря на то, что инфекция возникла на сроках до 4 недель, пациент попадает в специализированное учреждение в более поздние сроки, поэтому чаще приходится применять тактику двухэтапного протезирования [20,33]. При этом на амбулаторном этапе по месту жительства пациенту оказывается медицинская помощь, зачастую основанная на рекомендациях по приему аБ, что дает возможность микроорганизмам мутировать, вырабатывать механизмы защиты (селекция резистентных штаммов), что обусловливает скрытую клинику воспаления.…”

Section: таблица 4 исходы лечения ппиunclassified

“…При этом на амбулаторном этапе по месту жительства пациенту оказывается медицинская помощь, зачастую основанная на рекомендациях по приему аБ, что дает возможность микроорганизмам мутировать, вырабатывать механизмы защиты (селекция резистентных штаммов), что обусловливает скрытую клинику воспаления. Поскольку время до 4 недель часто бывает упущено, а, как известно, в более поздние сроки биопленка становится зрелой [20], основной тактикой лечения ППИ в большинстве случаев остается двухэтапная санация, что и применялось в нашем исследовании. Для проведения более эффективной санации на первом этапе нами были предприняты попытки поиска таких поверхностей имплантатов, которые обладали бы комплексом свойств, помогающих препятствовать формированию биопленок, обладали бактерицидностью наряду с биологической совместимостью.…”

Section: таблица 4 исходы лечения ппиunclassified

“…Хочется отметить, что отличные результаты были получены при непосредственном исследовании смывов с поверхности имплантатов после уЗобработки в отличие от исследования пунктатов и тканевых биоптатов. Этот метод отнесен нами к наиболее чувствительным в плане идентификации микроорганизмов, защищенных микробными биопленками [20,21,22]. При пункции сустава положительный микробиологический посев для установки диагноза ППИ достигает лишь 93% [30], для тканевых биоптатов чувствительность метода колеблется от 65 до 94% [24].…”

Section: таблица 4 исходы лечения ппиunclassified

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Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Николаев

Lyubimova²,

Любимова³

et al. 2019

Traumatology and Orthopedics of Russia

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Relevance. Formation of pan-resistance microorganisms, microbial biofilms on implants and recurrent infection rate stimulate the search for optimal prosthesis materials for treatment of periprosthetic infection (PJI). Purpose of the study — to compare the efficiency of two stage PJI treatment with simultaneous implantation of a spacer in combination with implants with silver-doped coatings based on two-dimensionally ordered linear chain carbon (TDOLCC+Ag) during the first stage and the conventional revision with a spacer only. Materials and methods. The study included 72 patients with PJI of the knee (n = 42) and hip (n = 30) joints. Control group (conventional revision) consisted of 35 patients and the main group (TDOLCC+Ag coated implant incorporated in a spacer) — 37 patients. Mean age of the patients was 61 years. Temporary components were replaced by the final components during revision at the second stage. Evaluation methods: clinical, X-ray, laboratory, microbiological and follow up history. Results. Inflammation markers and synovial fluid cytosis in the groups at the first revision stage featured equal high base values. During the second stage leucocyte count and cytosis reached normal values, ESR decreased twofold in both groups, CRP decreased five times in the main group. Throat and nasal swabs demonstrated growth of Staphylococcus aureus at 24,3-32,4% in both groups. The leading inducer of PJI was staphylococcal flora with MRSA share of 7,1% and MRSE — from 62,5 to 66,7%. End-points of evaluating treatment outcomes were revision spacer implantation at the second stage of sanation and recurrent PJI. Control group featured implantation of more revision spacers (5) as compared to the main group (1) after the treatment. Two recurrent PJIs were reported for the control group in 11 months while no recurrent infection was reported for the main group. Conclusion. The study demonstrated statistically significant improvement in the outcomes of PJI treatment by spacers with implants coated by TDOLCC+Ag as compared to the conventional treatment option.

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Section: таблица 4 исходы лечения ппиunclassified

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Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Николаев

Lyubimova²,

Любимова³

et al. 2019

Traumatology and Orthopedics of Russia

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Epidemiological surveillance of surgical site infections in large joint replacement

et al. 2022

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Joint replacement is a reliable and effective surgery that allows profound pain relief and restores joint function in patients. Despite the progress made and the experience gained in joint replacement, surgical site infection is one of the leading postoperative complications. It can proceed as a periprosthetic joint infection, osteomyelitis, sepsis and lead to disabled or dead outcomes. Systematization of risk factors for infectious complications plays an important role as an element of epidemiological surveillance system optimization. Age, the presence of concomitant diseases (for example, diabetes mellitus, cancer, arthritis and systemic collagenosis), carriage of antimicrobial-resistant microorganisms, infectious and inflammation both outside and in the area of surgery, and external factors (surgery duration, correct antibiotic prophylaxis and surgeon's experience) are the most significant risk factors for periprosthetic joint infection. In world practice, the National Nosocomial Infections Surveillance System surgical site infection risk index is used. This criterion does not consider all potential risk factors. It is important to analyze and rank the identified risk factors according to the impact on the development of infectious complications in organizing an epidemiological surveillance system process in a medical organization. Risk factors analysis will identify the most significant modifiable factors for the development, implementation and execution of organizational, preventive measures and epidemic control. The creation and implementation of a standardized preoperative protocol based on a risk factors assessment will allow predicting the surgery outcome and arguing the strategy and tactic of preventive measures.

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Practical recommendations concerning diagnostics of implant-associated infection in the course of endoprosthetics of large joints under modern conditions

Cited by 2 publications

References 0 publications

Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Treatment of Periprosthetic Infection with Silver-Doped Implants Based on Two-Dimensionally Ordered Linear Chain Carbon

Epidemiological surveillance of surgical site infections in large joint replacement

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