Evidence-based Approach for Prevention of Surgical Site Infection.

Mehmet Kursat Yilmaz, Nursanem Celik, Saad Tarabichi, Ahmad Abbaszadeh, Javad Parvizi
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Abstract

Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention. PJI not only affects patient outcomes but also increases mortality rates, thus its prevention is a matter of vital importance. The longer-term survival rates for PJI after total hip and knee arthroplasty correspond with or are lower than those for prevalent cancers in older adults while exceeding those for other types of cancers. Because of the multifaceted nature of infection risk, a collaborative effort among healthcare professionals is essential to implementing diverse strategies for prevention. Rigorous validation of the efficacy of emerging novel preventive techniques will be required. The combined application of these strategies can minimize the risk of infection, thus their comprehensive adoption is important. Collectively, the risk of PJI could be substantially minimized by application of a multifaceted approach implementing these strategies, leading to improvement of patient outcomes and a reduced economic burden.

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预防手术部位感染的循证方法。
假体周围关节感染(PJI)被认为是导致初次和翻修全关节成形术(TJA)失败的关键因素。随着 TJA 的发病率不断上升,预计 PJI 的发病率也会显著增加。病例数量的不断攀升,以及对医疗系统造成的巨大经济压力,都强调了制定有效预防策略的迫切性。PJI 不仅会影响患者的预后,还会增加死亡率,因此预防 PJI 至关重要。全髋关节和膝关节置换术后 PJI 的长期存活率与老年人常见癌症的存活率相当或更低,但却高于其他类型癌症的存活率。由于感染风险的多面性,医护人员之间的通力合作对于实施多样化的预防策略至关重要。需要对新出现的新型预防技术的有效性进行严格验证。这些策略的综合应用可将感染风险降至最低,因此全面采用这些策略非常重要。总之,通过采用多方面的方法来实施这些策略,可以大大降低 PJI 的风险,从而改善患者的治疗效果并减轻经济负担。
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Cement Filling Technique to Prevent Greater Trochanter Displacement in Hip Arthroplasty for Femoral Intertrochanteric Fracture: A Technical Note. Change of Sacral Slope according to the Surgical Position in Total Hip Arthroplasty. Complications and Healthcare Cost of Total Hip Arthroplasty in Patients with Depressive Disorder. Direct Anterior Approach in Total Hip Arthroplasty: A Single Center Experience. Evidence-based Approach for Prevention of Surgical Site Infection.
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