Açık distal tibia kırıklarında enfeksiyon gelişimi: Standart titanyum plak ile gümüş kaplı titanyum plak uygulamaları karşılaştırması

Year 2019, Volume: 12 Issue: 2, 293 - 299, 30.08.2019

Ahmet Yılmaz , Osman Çiloğlu

https://doi.org/10.26559/mersinsbd.570041

Abstract

Amaç: Bu çalışmada, standart titanyum plak ve gümüş kaplı
titanyum plak ile osteosentez yapılan açık distal tibia kırıklarında
enfeksiyon gelişimini karşılaştırmayı amaçladık. Yöntem: Gustilo-Anderson tip 1 ve tip 2 açık distal tibia kırığı
nedeniyle 2008-2016 tarihleri arasında biyolojik tesbit prensipleri ile
ameliyat edilen ve iki yılın üzerinde takibi yapılan 216 olguda enfeksiyon
gelişimi araştırıldı. Standart distal tibia titanyum plak 112 (%51.9) hastada
(Grup 1), gümüş kaplı distal tibia titanyum plak 104 (%48.1) hastada (Grup 2)
kullanıldı. Grup 1 de 68 hastada tip 1, 44 hastada tip 2 açık kırık vardı. Grup
2 de ise 58 hastada tip tip 1, 46 hastada tip 2 açık kırık mevcuttu. Bulgular: Grup 1 de 16 (tip 1’de beş
hasta, tip 2’de onbir hasta, %14.3) hastada, Grup 2 de tip 2 açık kırıklı üç
(%2.9) hastada enfeksiyon gelişti. Enfeksiyon gelişimi gümüş kaplı titanyum
plak ile osteosentez yapılan grupta anlamlı derecede düşük bulundu (p<0.05).
Gruplar arasında kaynama süreleri açısından istatistiksel fark bulunmadı
(p>0.05).  Grup 1’de 17 hasta, Grup 2’de 22 hastada
kaynama gecikmesi tesbit edildi. İki grup arasında
kaynama gecikmesi gösteren olgu sayıları açısından istatistiksel fark yoktu (p>0.05).
Enfeksiyon gelişen hastalarda aynı zamanda kaynama gecikmesi de saptandı. Sonuç: Gümüş kaplı titanyum plak ile
açık distal tbia kırıklarının osteosentezi enfeksiyonu önlemede etkin bulundu.
İmplantın gümüş ile kaplanmasının kırık kaynaması üzerinde etkisi tesbit
edilmedi.

Keywords

Açık kırıklar, osteosentez, enfeksiyon, biyofilm, gümüş

Supporting Institution

Destekleyen kurum yoktur

Infection development in open distal tibial fractures: A comparison of standard titanium plate applications with silver-coated titanium plate applications

Abstract

Aim: In this study, we aimed to
compare standard titanium plates and silver-Coated titanium plates used for
osteosynthesis in open distal tibial fractures, in terms of infection
development. Methods: We
investigated the development of infection in 216 patients who were operated on
based on the principles of biological fixation for Gustilo-Anderson Type 1 and
type 2 open distal tibial fractures between 2008 and 2016. 

Standard titanium plates were used in 112
patients (51.9%) (Group 1) and silver-coated titanium plates were used in 104
patients (48.1%) (Group 2). In Group 1, 68 patients had Type 1 and 44 patients
had Type 2 open fractures. In Group 2, 58 patients had Type 1, 46 patients had
Type 2 open fractures. Results:
Infection developed in sixteen patients in Group 1 (five patients with Type 1
and eleven patients with Type 2 fractures, 14.3%) and in three patients (2.9%)
with Type 2 open fractures in Group 2. The development of infection was
significantly lower in the group that underwent osteosynthesis using
silver-coated titanium plates (p<0.05). No statistically significant
difference was detected between the groups in terms of time to union
(p>0.05). 17 patients in Group 1 and 22 patients in Group 2 had delayed union.
There were no statistical differences between two groups in terms of case
numbers showing delayed union (p>0.05). Delayed union was observed in
all patients who developed infection. Conclusion:
Osteosynthesis of open distal tibial fractures with silver-coated titanium
plates was found to be effective in preventing infection. Based on our
observations, coating the implant with silver did not have any impact on
fracture union.

Keywords

Open fractures, osteosynthesis, infection, biofilm, silver

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