Abstract
To evaluate the effectiveness of various tactics in treating septic complications following large joint replacement.
Analysis of the outcomes of treatment 171 patients with SC following LJR from 2010 to 2014. Primary operations performed in 33 different hospitals; the time elapsed before complications from the date of primary intervention – from 3 days to 17 years. Depending on the type of complications, all patients were divided into 2 groups: those with superficial surgical site infections (SSSI) and deep surgical site infections (DSSI) associated with a prosthesis. In the treatment of these patients we followed different tactics using method of negative pressure wound therapy (NPWT), the antibiotic impregnated collagen sponge (AICS*) and antibacterial cement spacers (ACS).
We obtained the results allowing to assess the impact of these methods on the effectiveness of treatment, recurrence rate and mortality in patients of different groups. By combining different methods were able to reduce the number of relapses from 20% to 0% in patients with SSSI and significantly improve treatment outcomes in patients with DSSI. This analysis helped us to determine the most appropriate tactics of treatment depending on the type of complications.
The obtained results indicate the prospects of using NPWT, the AICS and ACS in the treatment of septic complications following large joint replacement and the role of these methods in the reduction of recurrence and mortality rates. Selection of the optimal tactics will significantly reduce the number of unsatisfactory results of treatment in these patients.
