摘要
背景:诱导膜技术是目前治疗肢体大段骨缺损尤其是骨髓炎清创术后骨缺损的有效方法之一,应用该技术治疗骨髓炎后感染复发率高达10%-15%,如何预防及降低感染复发是应用诱导膜技术治疗骨髓炎的关键。目的:探讨应用诱导膜技术治疗骨髓炎后如何降低感染复发的要点。方法:检索PubMed、中国知网、万方数据库中2010年1月至2021年3月的相关文献,英文检索词为“Masquelet technique;induced membrane technique;bone infection;osteomyelitis;soft tissue reconstruction;antibiotics;negative pressure wound therapy;debridement”;中文检索词为“Masquelet技术;诱导膜技术;骨感染;骨髓炎;软组织重建;抗生素;负压创面治疗;清创”。将如何降低应用Masquelet技术治疗骨髓炎后感染复发率的相关内容进行归纳总结。结果与结论:清创技术的改良、优化抗生素的应用方法、局部软组织重建方法及创面负压治疗技术的改进是降低诱导膜技术治疗骨髓炎术后感染复发的四大要点。抗生素载体负载靶向抗生素作用于感染灶,可以有效提高局部抗生素的抑菌性。如何精准调控局部抗生素释放曲线以应对局部细菌不同时机的负荷变化是未来学者需要进一步研究的方向。降低高抗生素释放量对诱导膜生物性的影响,将抗生素载体技术与诱导膜技术联合应用是未来诱导膜技术治疗骨髓炎的研究热点。
BACKGROUND:Masquelet technique is one of the effective methods for the treatment of large segmental bone defects of extremities,especially after debridement of osteomyelitis.The recurrence rate of infection after treatment of osteomyelitis is as high as 10%-15%.How to prevent and reduce infection recurrence is the key to the application of Masquelet technology in the treatment of osteomyelitis.OBJECTIVE:To explore the key points of how to reduce the recurrence of infection after the application of Masquelet technique in the treatment of osteomyelitis.METHODS:The relevant articles from January 2010 to March 2021 were searched on PubMed,CNKI and Wanfang databases,with English search term as“Masquelet technique;induced membrane technique;bone infection;osteomyelitis;soft tissue reconstruction;antibiotics;negative pressure wound therapy;debridement”;Chinese search terms were“Masquelet technology;induced membrane technique;bone infection;osteomyelitis;soft tissue reconstruction;antibiotics;negative pressure wound therapy;debridement”.The related contents of how to reduce the recurrence rate of infection after the application of Masquelet technology in the treatment of osteomyelitis were summarized.RESULTS AND CONCLUSION:The improvement of debridement technique,the optimization of the application of antibiotics,the improvement of local soft tissue reconstruction and the improvement of negative pressure wound therapy are the four main points to reduce the recurrence of infection after osteomyelitis treated by Masquelet technique.The action of targeted antibiotics loaded with antibiotic carriers on the focus of infection can effectively improve the bacteriostasis of local antibiotics.How to accurately regulate the local antibiotic release curve to cope with the change of local bacterial load at different times is the direction that scholars need to further study in the future.Reducing the effect of high antibiotic release on the biological properties of induced membrane,the combined application of antibiotic carrier technology and induced membrane technology is the research focus of Masquelet technology in the treatment of osteomyelitis in the future.
作者
慈文韬
章鑫隆
闫石
王钊
Ci Wentao;Zhang Xinlong;Yan Shi;Wang Zhao(Department of Traumatology and Orthopedics,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2022年第28期4546-4552,共7页
Chinese Journal of Tissue Engineering Research
关键词
诱导膜技术
骨髓炎
感染复发
抗生素
清创术
软组织重建
负压创面治疗
Masquelet technique
osteomyelitis
infection recurrence
antibiotics
debridement
soft tissue reconstruction
negative pressure wound therapy
