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<p>The management of fracture-related infection (FRI) with Debridement, Antibiotics, Irrigation, and Implant Retention (DAIR) is an appealing option, but its suitability is restricted to a relatively narrow proportion of patients. This study aimed to create a large animal model of DAIR after FRI and to evaluate outcomes after early (2 weeks) and delayed (5 weeks) DAIR. Additionally, intramedullary lavage (IML) of the intramedullary canal (IMC) is introduced as a novel technique to remove infected tissue. Our findings showed that DAIR failed to resolve infections in both early and delayed groups, whilst IML significantly reduced bacterial counts, leading to culture-negative results in the soft tissue and bone marrow. IML did not compromise long-term bone healing as revealed by an implant load sensor on the plate. In conclusion, DAIR was successfully achieved in a new large animal model with minimal losses. The IML method improves treatment efficacy, potentially broadening the range of patients suitable for DAIR.</p>

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Irrigation of the intramedullary channel improves outcome of DAIR in a sheep model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月24日

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  • Claudia Siverino,
  • Lena Gens,
  • Tim Buchholz,
  • Caroline Constant,
  • Manuela Ernst,
  • Dominic Gehweiler,
  • Mario Morgenstern,
  • R. Geoff Richards,
  • Henning Richter,
  • Niels Vanvelk,
  • Maja Waschk,
  • Markus Windolf,
  • Stephan Zeiter,
  • T. Fintan Moriarty

摘要

The management of fracture-related infection (FRI) with Debridement, Antibiotics, Irrigation, and Implant Retention (DAIR) is an appealing option, but its suitability is restricted to a relatively narrow proportion of patients. This study aimed to create a large animal model of DAIR after FRI and to evaluate outcomes after early (2 weeks) and delayed (5 weeks) DAIR. Additionally, intramedullary lavage (IML) of the intramedullary canal (IMC) is introduced as a novel technique to remove infected tissue. Our findings showed that DAIR failed to resolve infections in both early and delayed groups, whilst IML significantly reduced bacterial counts, leading to culture-negative results in the soft tissue and bone marrow. IML did not compromise long-term bone healing as revealed by an implant load sensor on the plate. In conclusion, DAIR was successfully achieved in a new large animal model with minimal losses. The IML method improves treatment efficacy, potentially broadening the range of patients suitable for DAIR.