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Mini Review on the Impact of Mobile Parts’ Exchange During the DAIR Procedure (Debridement, Antibiotics, Irrigation, Retention) for Infected Total Joint Arthroplasties


Bezel, P; Fucentese, S F; Burkhard, J; Holy, D; Nieuwland, A J; Burkhard, M; Uçkay, I (2019). Mini Review on the Impact of Mobile Parts’ Exchange During the DAIR Procedure (Debridement, Antibiotics, Irrigation, Retention) for Infected Total Joint Arthroplasties. Journal of Infectiology:13-17.

Abstract

A prosthetic joint infection (PJI) requires a combined approach (infectiology and surgery). The therapeutic DAIR approach (debridement, antibiotics, irrigation, and retention) is an option for acute and stable PJI yielding remission incidences that oscillate between 70% and 90%; in a literature mostly composed of retrospective single-center trials. DAIR can be performed with or without mobile part’s exchange during debridement. Scientific data proving the necessity of mobile part exchanges (by leaving other infected components in situ) remain scarce. In this narrative mini review, we evaluate the existing literature that analyses the benefit of exchanging mobile parts with at least ten own cases. We moreover discuss the optimal duration of concomitant targeted systemic antibiotic therapy and reveal some insights in the surgical difficulties in performing DAIR. Our conclusion tends to favor of the mobile part’s exchange whenever feasible.

Abstract

A prosthetic joint infection (PJI) requires a combined approach (infectiology and surgery). The therapeutic DAIR approach (debridement, antibiotics, irrigation, and retention) is an option for acute and stable PJI yielding remission incidences that oscillate between 70% and 90%; in a literature mostly composed of retrospective single-center trials. DAIR can be performed with or without mobile part’s exchange during debridement. Scientific data proving the necessity of mobile part exchanges (by leaving other infected components in situ) remain scarce. In this narrative mini review, we evaluate the existing literature that analyses the benefit of exchanging mobile parts with at least ten own cases. We moreover discuss the optimal duration of concomitant targeted systemic antibiotic therapy and reveal some insights in the surgical difficulties in performing DAIR. Our conclusion tends to favor of the mobile part’s exchange whenever feasible.

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Item Type:Journal Article, not_refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:12 August 2019
Deposited On:12 Feb 2020 10:55
Last Modified:14 Feb 2020 14:32
Publisher:s.n.
OA Status:Green
Free access at:Official URL. An embargo period may apply.
Official URL:https://www.infectiologyjournal.com/articles/mini-review-on-the-impact-of-mobile-parts-exchange-during-the-dair-procedure-debridement-antibiotics-irrigation-retention-for-infe.pdf

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