Browsing by Keyword "infection"
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Item INFECCION DE PROTESIS DE CADERA: APROXIMACION DIAGNOSTICA Y TRATAMIENTO DE 27 EPISODIOS(1994) Salavert Lleti, M.; Martinez, J.; Sanchez, C.; Matamala, A.; Pons, M.; Angles, F.; Cuchi, E.; Lite, J.; Ferrer, H.; Garau, J.; ADAPTACIÓN AL CAMBIO CLIMÁTICOBackground: Preoperative diagnosis of hip prosthesis infection (HPI) is difficult. There is no therapeutic option which is completely effective and without risk. The aim of this study was to evaluate a diagnostic approach and therapeutic strategy in a group of patients with HPI. Patients and Methods: A retrospective study of 27 episodes of HPI diagnosed by anatomopathologic and/or microbiologic examination of surgical samples was performed. Results: Twenty-three patients with 27 episodes of HPI out of a total of 24 hip prosthesis (HP) were treated. The infection was early in 15 episodes. The etiologic agents were plasmocoagulase negative staphylococcus (NSP) in 11 cases, P. aeruginosa in 8, S. aureus in 5, Enterococcus sp. in 2 and miscellaneous in the remaining cases. In 2 cases the infection was polymycrobial. Following a mean follow period of 22.6 ± 15.2 months, 13 out of the 14 patients in whom the prosthesis was withdrawn were cured (in 4 a second prosthesis was implanted), one out of 6 in those in whom the prosthesis remained in situ following debridement, and 2 out of 3 episodes in whom reimplantation was performed over time. The withdrawal of the prosthesis was significantly greater than debridement in the treatment of early infection (p < 0.001). The total mean length of postoperative antibiotherapy was 48.2 ± 17 days. No differences were observed in the oral versus parenteral treatment (p = 0.22), and nor was prognosis worse in those treated for less than 42 days. Conclusions: The authors' experience suggests that attempts to save a hip prosthesis in early infection usually fail. In addition to prosthesis withdrawal or implantation of another prosthesis, six weeks of postoperative antibiotic therapy, which may be oral route, appear to be sufficient.Item Plasma polymerized silylated ciprofloxacin as an antibiotic coating(2011-07-22) Braceras, Inigo; Azpiroz, Patxi; Briz, Nerea; Fratila, Raluca M.; Oyarbide, Joseba; Ipiñazar, Enrique; Úlvarez, Noelia; Atorrasagasti, Garbiñe; Aizpurua, Jesus M.; INGENIERÍA DE SUPERFICIES; TECNOLOGÍAS DE HIDRÓGENO; SG; VALORIZACIÓN DE RESIDUOS; BiomaterialesLocally applied antibiotics under temporally controlled release present many advantages over systemic clinical treatments, e.g. efficiency and side effects. This can be achieved by a coating on top of the medical device, in which the antibiotic is stored. This study presents the use of plasma polymerization to produce such a coating using N,O-bis-tert- butyldimethylsilylated ciprofloxacin (silylciprofloxacin) as a precursor. Once exposed to physiological media, the outer layers of the coating release the antibiotic by a hydrolysis reaction. Thus, the plasma process parameters can control the speed of liberation through the coating polymerization. Besides, this study shows that the release products present antibiotic activity against a number of bacteria: E. coli, P. aeruginosa, and S. aureus. Ciprofloxacin release dynamics can be controlled by coating plasma polymerization parameters, allowing local controlled delivery of active antibiotic in physiologic conditions, and thus higher efficiency and lower side effects.