Emprego do músculo gastrocnêmio no tratamento das lesões infectadas do joelho

Souza, Fabiano Inácio de; Zumiotti, Arnaldo Valdir; Júnior, Rames Mattar; Wei, Teng Hsiang; Resende, Marcelo Rosa de; Torres, Luciano Ruiz

doi:10.1590/s1413-78522009000400010

Cited by 4 publications

(2 citation statements)

References 28 publications

(27 reference statements)

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“…In our study, the flaps remained viable in ~ 89% of cases with similar results to those found in the literature 23 - 25 that demonstrated high rates of success, as Markovich et al 6 with a 100% rate; and Gerwin et al 12 with a 92% rate, even though in these studies we also found heterogeneous groups as mentioned above.…”

Section: Discussionsupporting

confidence: 91%

“…The flap cover is considered a good option for cases of skin loss and prosthesis exposure. 6 , 11 , 14 , 16 , 17 , 23 Nahabedian et al 24 with 29 cases and Casey el al. 16 with 41 cases overall, 18 of them being of post-TKA flaps cases are some of the largest series, but have quite heterogeneous groups in which we found cases with and without infection, different types of flaps regarding the donor site and cases not associated with TKA.…”

Section: Discussionmentioning

confidence: 98%

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Retalhos de rotação para cobertura após artroplastia total de joelho

et al. 2013

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OBJECTIVE: To evaluate the results obtained using local myocutaneous rotation flaps in cases of wound dehiscence after total knee arthroplasty. METHODS: Patients undergoing these surgical procedures were selected in the 2000-2012 period. The nine selected cases during this period were subjected to flap coverage due to skin dehiscence associated with infection. In eight cases we used rotation flaps of the medial gastrocnemius, and in one case we used advancing skin. RESULTS: Eighty nine percent of the cases were successful in the coverage of the prosthesis and the viability of the flaps. In four cases it was possible to maintain or review the prosthesis. Four other cases progressed to amputation due to failure on treatment of infections, and one case remained without the prosthesis. The functional evaluation showed an unsatisfactory outcome in 89% of cases. CONCLUSION: Coverage flaps are a good option for the treatment of cases of dehiscence with exposure of the prosthesis and the functional failure was associated with the inability to control the infection and the damage it caused. Level of Evidence IV, Case Series.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Retalhos de rotação para cobertura após artroplastia total de joelho

et al. 2013

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Insights into treatment and outcome of fracture-related infection: a systematic literature review

Bezstarosti

Lieshout

Voskamp

et al. 2018

Arch Orthop Trauma Surg

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IntroductionStandardized guidelines for treatment of fracture-related infection (FRI) are lacking. Worldwide many treatment protocols are used with variable success rates. Awareness on the need of standardized, evidence-based guidelines has increased in recent years. This systematic literature review gives an overview of available diagnostic criteria, classifications, treatment protocols, and related outcome measurements for surgically treated FRI patients.MethodsA comprehensive search was performed in all scientific literature since 1990. Studies in English that described surgical patient series for treatment of FRI were included. Data were collected on diagnostic criteria for FRI, classifications used, surgical treatments, follow-up protocols, and overall outcome. A systematic review was performed according to the PRISMA statement. Proportions and weighted means were calculated.ResultsThe search yielded 2051 studies. Ninety-three studies were suitable for inclusion, describing 3701 patients (3711 fractures) with complex FRI. The population consisted predominantly of male patients (77%), with the tibia being the most commonly affected bone (64%), and a mean of three previous operations per patient. Forty-three (46%) studies described FRI at one specific location. Only one study (1%) used a standardized definition for infection. A total of nine different classifications were used to guide treatment protocols, of which Cierny and Mader was used most often (36%). Eighteen (19%) studies used a one-stage, 50 (54%) a two-stage, and seven (8%) a three-stage surgical treatment protocol. Ten studies (11%) used mixed protocols. Antibiotic protocols varied widely between studies. A multidisciplinary approach was mentioned in only 12 (13%) studies.ConclusionsThis extensive literature review shows a lack of standardized guidelines with respect to diagnosis and treatment of FRI, which mimics the situation for prosthetic joint infection identified many years ago. Internationally accepted guidelines are urgently required to improve the quality of care for patients suffering from this significant complication.

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