FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to purulent surgery, traumatology and orthopedics, and can be used for surgical treatment of purulent osteoarthritis and deep periprosthetic infection. Method for preparation of infected periarticular wound for implantation of permanent or temporary stabilizing device includes access to joint, osteonecretomy, removal of endoprosthesis components and/or joint resection, surgical treatment of periarticular wound, installation of preliminary formed spacer, cytological and microbiological control of separated and closing of wound. Prior to installation of spacer NPWT-system is installed and wound is temporarily closed. After 48–72 hours NPWT-system is removed, if signs of recurrent infection are detected, surgical treatment of wound is repeated, NPWT-system is installed. If there are no signs of recurrent infection, the NPWT system is removed, a spacer or an external fixation apparatus is inserted, or intramedullary osteosynthesis is performed with a block rod. Wound is closed in layers with the gravitation drainage installation for 1–3 days. After drainage is removed, diagnostic puncture of periarticular cavity is performed in 4–5 days. 1.5–2 months later, the puncture is repeated, cytological and microbiological control of the discharge is performed, and if observing signs of recurrent infection, a spacer is reestablished, and if there are no signs of recurrence, the spacer is replaced with a permanent endoprosthesis.
EFFECT: method provides reduced probability of wound reinfection and reduced length of treatment ensured by using the NPWT system prior to installation of the spacer.
1 cl, 3 dwg, 1 ex
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Authors
Dates
2020-01-23—Published
2018-09-25—Filed