Phase Ⅰ debridement combined with antibiotic bone cement bead chain packing for chronic infection after fracture / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical effect of phase Ⅰ debridement combined with antibiotic bone cement bead chain packing for chronic infection after fracture.Methods A retrospective case series study was carried out to analyze the clinical data of 50 patients with chronic bone infection admitted to Wuhan Union Hospital from February 2015 to June 2017.There were 38 males and 12 females,aged 28-70 years [(48.4 ± 5.1) years].In terms of the infection site,there were 36 patients at the humerus,seven at the femur,three at the phalanges,two at the calcaneus,and two at the spine.A total of 42 infection patients were reported after internal fixation,and eight infection patients were reported after fracture.All patients were treated with phase I debridement combined with antibiotic bone cement bead chain packing.The changes of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before operation and 1,4 and 7 days after operation,infection control rate,number of debridement operations,bone healing time after bone grafting,and infection recurrence rate were recorded.Results The patients were followed up for 6-22 months [(12.4 ± 2.9) months].At postoperative 1,4 and 7 days,the preoperative ESR [(41.2 ± 5.3) mm/h] and preoperative CRP [(83.2 ± 9.3) mg/L] were decreased to (37.1 ± 4.8) mm/h,(32.5 ± 3.1) mm/h,(22.3 ± 1.9) mm/h and (71.1 ± 4.6)mg/L,(66.5 ± 3.1) mg//L,(39.3 ± 1.9) mg/L,respectively (P ＜ 0.05).The infection control rate was 94％ (47/50),and the number of debridement operations was 2-5 [(2.2 ± 0.3)].The bone healing time was 14-30 weeks [(24.6 ± 6.7) weeks],and the infection recurrence rate was 2％ (1/47).Conclusion Phase I debridement combined with antibiotic bone cement bead chain packing is an ideal method in treating chronic bone infection,with high infection control rate,low recurrence rate,and satisfactory bone union.