title: Implant-related infection in the tibia: surgical revision strategy with vancomycin cement.
abstract: The development of a deep wound infection in the presence of internal hardware presents a clinical dilemma. The purpose of the present study was to evaluate the treatment outcomes of vancomycin cement with other advances of surgical techniques for implant-related infection (IRI) in the tibia. This study included 217 consecutive patients who had sustained IRI of the tibia. Of them, 152 patients had soft tissue defects and the internal hardware was exposed. Repeated debridement and negative pressure assisted closure were used. All the infected internal hardware was removed. External fixations and flaps were used. Custom-made vancomycin cement was inserted into the dead space of the wounds and left in site for a month. The follow-up was from 12 months to 108 months, averaging 37.5 months. For all the 217 patients, the general osteomyelitis healing rate and bone union rate were 86.6% and 97.2%, respectively. This study shows high rates of healing of IRI in the tibia if the new advances of surgery could be effectively combined into the treatment strategy with vancomycin cement as an important treatment.
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Yong-Qing
authors.initials: YQ
authors.lastname: Xu
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Yue-Liang
authors.identifier: 0000-0003-2006-9403
authors.initials: YL
authors.lastname: Zhu
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Xin-Yv
authors.initials: XY
authors.lastname: Fan
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Orthopaedic Department, Kunming General Hospital of Chengdu Military Region, No. 212, Daguan Road, Kunming, Yunnan 650032, China.
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: He
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001843:Bone Cements / Q000627:therapeutic use*; D003646:Debridement / Q000379:methods; D004866:Equipment Contamination; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D014640:Vancomycin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D014640:Vancomycin