Objective To develope a modified surgical lavage tube to improve the efficacy of the treatment of orthopaedic postoperative infection. Methods A retrospective analysis was performed on 126 patients who received the pulsed lavage therapy with side-hole double valve lavage tube between March 2005 and March 2010. There were 98 males and28 females, aged 19-63 years (mean, 35 years). The infected sites included femur in 61 cases, tibiofibula in 46 cases, humerus in 12 cases, and patella in 7 cases. The lavage tube obstruction and defluvium, secondary infection of drainage opening, and wound heal ing were observed during treatment. Results No lavage tube defluvium occured during the lavage in all cases. Lavage tube obstruction occurred in 68 cases, edema at the peri pheral tissue was caused by obstruction in 9 cases; secondary infection at the lavage and drainage opening in 10 cases, which were cured after corresponding treatment. All cases achieved wound healing by first intention within 2 weeks. Lavage tube and drainage opening were closed within 1 month. All patients were followed up 1-5 years (mean, 18 months) with no recurrence. Conclusion Pulsed lavage therapy with side-hole double valve lavage tube can obviously improve the efficacy of the treatment of orthopaedic postoperative infection, so it is an effective modification to convention lavage.
ObjectiveTo explore the effectiveness of induced membrane technique of hollow porous antibioticimpregnated bone cement forming in vitro and lavage in vivo for the treatment of osteomyelitis. MethodsBetween January 2010 and March 2014, 14 cases of osteomyelitis were treated by induced membrane technique of hollow porous antibiotic-impregnated bone cement forming in vitro and lavage in vivo after debridement at the first stage, then the bone cement with bone graft was replaced during the induced membrane after infection was controlled at the second stage. The time from first to second stage operation was 8-12 weeks (average, 10.2 weeks). There were 11 males and 3 females, aged 18 to 69 years (average, 39.2 years). According to Cierny-Mader classification of osteomyelitis, 2 cases were rated as intramedullary type, 5 cases as limited type, and 7 cases as diffusing type. The course of osteomyelitis was 3 months to 20 years, averaged 1.9 years. The healing of bone defect and the functionary recovery of adjacent joint were evaluated according to Paley's method. ResultsDebridement was performed for two times in 1 case, and for one time in 13 cases for control of bone infection at the first stage. All incisions healed by first intention after second stage. All patients were followed up 15-48 months (average, 13.4 months), with no recurrence of infection. All bone defects healed, and the clinical healing time was 4-5 months (average, 4.4 months). The results of bone healing grade were excellent in all cases at 1 year after operation; the functional recovery of adjacent joint at last follow-up was excellent in 4 cases, good in 8 cases, and fair in 2 cases, and the excellent and good rate was 85.7%. ConclusionInduced membrane technique of hollow porous antibiotic-impregnated bone cement forming in vitro and lavage in vivo for treatment of osteomyelitis has the advantages of high rate of elution of antibiotics, ease of lavage of medullary cavity, and no damage to induced membrane and bony interface between bone and bone cement when removing cement, it is effective for control of bone infection and repair of bone defect.