Irrigation of the intramedullary channel improves outcome of DAIR in a sheep model.

IF 9.2 1区生物学 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY npj Biofilms and Microbiomes Pub Date : 2025-02-24 DOI:10.1038/s41522-024-00643-0

Claudia Siverino, Lena Gens, Tim Buchholz, Caroline Constant, Manuela Ernst, Dominic Gehweiler, Mario Morgenstern, R Geoff Richards, Henning Richter, Niels Vanvelk, Maja Waschk, Markus Windolf, Stephan Zeiter, T Fintan Moriarty

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Abstract

The management of fracture-related infection (FRI) with Debridement, Antibiotics, Irrigation, and Implant Retention (DAIR) is an appealing option, but its suitability is restricted to a relatively narrow proportion of patients. This study aimed to create a large animal model of DAIR after FRI and to evaluate outcomes after early (2 weeks) and delayed (5 weeks) DAIR. Additionally, intramedullary lavage (IML) of the intramedullary canal (IMC) is introduced as a novel technique to remove infected tissue. Our findings showed that DAIR failed to resolve infections in both early and delayed groups, whilst IML significantly reduced bacterial counts, leading to culture-negative results in the soft tissue and bone marrow. IML did not compromise long-term bone healing as revealed by an implant load sensor on the plate. In conclusion, DAIR was successfully achieved in a new large animal model with minimal losses. The IML method improves treatment efficacy, potentially broadening the range of patients suitable for DAIR.

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在绵羊模型中，髓内通道的灌溉改善了DAIR的结果。

用清创、抗生素、冲洗和植入物保留（DAIR）治疗骨折相关感染（FRI）是一种很有吸引力的选择，但其适用性仅限于相对狭窄的患者比例。本研究旨在建立FRI后DAIR的大型动物模型，并评估早期（2周）和延迟（5周）DAIR的结果。此外，髓内管（IMC）的髓内灌洗（IML）被介绍为一种新的技术，以清除感染组织。我们的研究结果表明，DAIR不能解决早期和延迟组的感染，而IML显著减少细菌计数，导致软组织和骨髓培养阴性结果。钢板上的植入物负荷传感器显示，IML不影响长期骨愈合。总之，DAIR在新的大型动物模型中成功实现，损失最小。IML方法提高了治疗效果，潜在地扩大了适合DAIR的患者范围。

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来源期刊

npj Biofilms and Microbiomes Immunology and Microbiology-Microbiology

CiteScore

12.10

自引率

3.30%

发文量

审稿时长

9 weeks

期刊介绍： npj Biofilms and Microbiomes is a comprehensive platform that promotes research on biofilms and microbiomes across various scientific disciplines. The journal facilitates cross-disciplinary discussions to enhance our understanding of the biology, ecology, and communal functions of biofilms, populations, and communities. It also focuses on applications in the medical, environmental, and engineering domains. The scope of the journal encompasses all aspects of the field, ranging from cell-cell communication and single cell interactions to the microbiomes of humans, animals, plants, and natural and built environments. The journal also welcomes research on the virome, phageome, mycome, and fungome. It publishes both applied science and theoretical work. As an open access and interdisciplinary journal, its primary goal is to publish significant scientific advancements in microbial biofilms and microbiomes. The journal enables discussions that span multiple disciplines and contributes to our understanding of the social behavior of microbial biofilm populations and communities, and their impact on life, human health, and the environment.