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New Strategies for Bone Infection Management.
Veterinary and Comparative Orthopaedics and Traumatology ( IF 1.3 ) Pub Date : 2020-07-20 , DOI: 10.1055/s-0040-1714294
Kenneth A Johnson 1
Affiliation  

Bone infection associated with open fractures and internal fixation implants in human patients is the focus of multidisciplinary research initiatives by the AO Foundation, due to the serious morbidity of this complication.[1] An early study published in 1980 reported an incidence of osteomyelitis in canine fractures of approximately 31%.[2] However, apart from the complication of bone infection after elective tibial osteotomy for cranial cruciate disease, there is a shortage of more contemporary studies about fracture-related infections in veterinary patients.[3]

The classic work of Rittman and Perren using an infected sheep tibial model demonstrated that bone could heal in the face of infection, provided stable internal fixation was maintained.[4] However following the achievement of clinical union, biofilm formation on implants, causing recurrence of infection usually requires implant removal. Strategies to enhance the efficacy of local antimicrobial drug administration in chronic osteomyelitis include the use of sustained release carriers.[3] Furthermore, using a rat tibial model of implant-related bone infection with methicillin-resistant Staphylococcus aureus, the co-administration of leech saliva with erythromycin was evaluated recently.[5] This treatment reduced the severity of histopathological scores for bone infection. However, neither leech saliva alone, or in combination with erythromycin, had any effect on reducing bacterial load in the infected tibial tissue. Previous studies report that leech saliva has anti-bacterial effects; but its clinical use in veterinary patients with chronic bone infections cannot not be currently recommended.[5] It does however highlight the need to build on the research findings of the AO focus group on fracture-related infection using animal models, to improve upon the documentation and treatment of these problems in our clinical veterinary patients.



中文翻译:

骨感染管理的新策略。

由于这种并发症的严重发病率,人类基金会与开放性骨折和内固定植入物相关的骨感染是AO基金会多学科研究计划的重点。[1] 1980年发表的一项早期研究报告说,犬骨折中骨髓炎的发生率约为31%。[2] 然而,除了颅骨交叉疾病的选择性胫骨截骨术后的骨感染并发症外,还缺乏更多有关兽医患者骨折相关感染的当代研究[3]。

Rittman和Perren使用受感染的绵羊胫骨模型进行的经典工作表明,只要保持稳定的内固定,骨头就可以在感染的情况下he愈。[4] 然而,随着临床结合的实现,植入物上的生物膜形成,导致感染复发通常需要去除植入物。提高在慢性骨髓炎中使用局部抗菌药物的疗效的策略包括使用缓释载体。[3] 此外,使用大鼠胫骨模型植入性骨相关的耐甲氧西林金黄色葡萄球菌感染最近评估了水ech唾液与红霉素的共同给药。[5] 这种治疗降低了骨感染的组织病理学评分的严重性。然而,单独的水ech唾液,或与红霉素联合使用,都不会降低感染的胫骨组织中的细菌负荷。先前的研究报告说,水ech唾液具有抗菌作用。但目前尚不推荐在患有慢性骨感染的兽医患者中使用其临床应用。[5] 但是,它的确强调了需要利用动物模型在AO骨折相关感染的焦点小组的研究结果的基础上,以改善我们临床兽医患者中这些问题的文献记录和治疗。

更新日期:2020-07-21
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