tailieunhanh - Cách Sử dụng kháng sinh

Việc sử dụng xi măng ngâm tẩm kháng sinh trong tổng số thủ tục sửa đổi arthroplasty hông của IS rộng rãi, và một Thân Thể Thể hiện bằng chứng hiệu quả đáng kể trong việc phòng chống nhiễm trùng và điều trị STI. Tuy nhiên, đó là không rõ ràng đó Nó là cần thiết hay mong muốn như là một phương tiện dự phòng | Use of Antibiotic-Impregnated Cement in Total Joint Arthroplasty Thomas N. Joseph MD Andrew L. Chen MD and Paul E. Di Cesare MD Abstract The use of antibiotic-impregnated cement in revision of total hip arthroplasty procedures is widespread and a substantial body of evidence demonstrates its efficacy in infection prevention and treatment. However it is not clear that it is necessary or desirable as a routine means of prophylaxis in primary total joint arthroplasty. In the management of infected implant sites antibiotic-impregnated cement used in one-stage exchange arthroplasties has lowered reinfection rates. In two-stage procedures use of beads and either articulating or nonarticulating antibiotic-impregnated cement spacers also has lowered reinfection rates. In addition spacers reduce dead space help stabilize the limb and facilitate reimplantation. Problems associated with antibiotic-impregnated cement in total joint arthroplasty include weakening of the cement and the generation of antibiotic-resistant bacteria in infected implant sites. J Am Acad Orthop Surg 2003 11 38-47 In 1970 Buchholz and Engelbrecht1 introduced the concept of impregnating acrylic bone cement with antibiotic as a possible means of preventing infection in patients undergoing total joint arthroplasty. Since then antibiotic-impregnated cement has become more commonly used for revision total joint arthroplasty and as antibiotic-impregnated cement spacers or beads for treatment of infection during two-stage revision arthroplasty than it has for infection prophylaxis in primary total joint arthroplasty. Even without the contribution of antibiotic-impregnated cement the infection rate after standard primary total joint arthroplasty in modern operating rooms has been reduced to between and 2 . A survey from 1995 concerning orthopaedic operating room practices and equipment suggested that this reduction has been achieved by the access to laminar airflow present in 49 of hospital operating rooms