METHOD OF TREATING THE PATIENTS WITH CHRONIC RECURRENT PERIPROSTHETIC HIP JOINT INFECTION CAUSED BY ANTIBIOTIC-RESISTANT MICROORGANISMS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgery, traumatology and orthopedics, and can be used in stage treatment of patients with chronic recurrent periprosthetic hip infection caused by microbial pathogens with high resistance to antibiotics. Method involves a two-stage complex surgical treatment, wherein at the first stage after removal of all previously installed orthopedic structures and materials, including bone cement, a radical surgical treatment of the periprosthetic infection focus is performed. Bone tissue affected by osteomyelitis process is removed, and compromised surrounding soft tissues are excised. Formed tissue cavity is then filled by non-free transplantation of an islet flap from the lateral broad muscle of thigh. This island muscular flap is moved on a constant vascular pedicle including a descending branch of the lateral envelope of the femoral artery and accompanying similar veins. Postoperative period involves an antibiotic course of at least 8 weeks. Further, in the patients with long-term remission of the infectious process, a second stage of surgical management, revision replacement surgery, is performed not earlier than 12 months after the first operation. In postoperative period repeated course of antibiotic therapy for at least 8 weeks.;EFFECT: method provides higher clinical effectiveness and possibility of further recovery of lower extremity support ability by means of revision hip replacement due to absence of foreign body infection, which can serve as a basis for microbial biofilm formation, as well as good blood supply of an islet muscular flap replacing the cavity in the region of the hip joint formed during radical surgical treatment.;1 cl, 4 dwg, 1 ex