臨床整形外科53巻5号

2018年05月発行

誌上シンポジウム 外傷後・術後骨髄炎の治療

骨折観血的整復固定術後の急性・遅発性感染の治療

著者： 新倉隆宏¹

所属機関： ¹神戸大学大学院医学研究科外科系講座整形外科学

ページ範囲：P.361 - P.365

　骨折観血的整復固定術後感染の治療指針として，晩期の慢性骨髄炎，感染性偽関節に対する治療と，術後早期の感染では異なることがある．早期感染ではインプラント温存を試みることができる場合がある．術後約2週までの急性(早期)感染ではデブリドマン，抗菌薬治療でまずはインプラント温存を試みることもできる．術後約10週までの遅発性感染では，インプラントに十分な骨折部固定力があれば温存も可能といわれている．ただし，骨折観血的整復固定術後感染の治療目標の1つは慢性骨髄炎への移行阻止であり，インプラント温存治療が不調である場合にはこれに固執すべきではない．

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