Evidence-based uncertainty: do implant-related properties of titanium reduce the susceptibility to perioperative infections in clinical fracture management? A systematic review
| Autor: | Gerhard Schmidmaier, Patrick Haubruck, Michael C. Tanner, Christian Fischer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Evidence-based practice MEDLINE Dentistry Review Cochrane Library law.invention 03 medical and health sciences Fracture Fixation Internal Fractures Bone 0302 clinical medicine Randomized controlled trial law Titanium implants Medicine Humans 030212 general & internal medicine Titanium 030222 orthopedics Osteosynthesis business.industry technology industry and agriculture Uncertainty Implant related infection General Medicine Perioperative Stainless Steel Trauma surgery Infectious Diseases Stainless steel implants Implant business Infection Prevention of infection |
| Zdroj: | Infection |
| ISSN: | 1439-0973 0300-8126 |
| Popis: | Background Implant-associated infections (IAI) remain a challenging complication in osteosynthesis. There is no consensus or clear evidence whether titanium offers a relevant clinical benefit over stainless steel. Purpose In this systematic review, we sought to determine whether the implant properties of titanium reduce the susceptibility to IAI compared to stainless steel in fracture management. Methods A systematic literature search in German and English was performed using specific search terms and limits. Studies published between 1995 and 1st June 2020 in the Cochrane library, MEDLINE and Web of Science databases were included. Only clinical studies comparing titanium and stainless steel implants regarding the susceptibility to infections were selected for detailed review. Results Five studies out of 384 papers were identified and reviewed. From the studies meeting inclusion criteria one study was a systematic review, two studies were randomized controlled studies (RCT) and two studies were of retrospective comparative nature of level IV evidence. Conclusion Our results show that currently, no proven advantage for titanium implants in respect to IAI can be seen in contemporary literature. Implants preserving periosteal blood-flow and minimising soft-tissue trauma show statistically significant benefits in reducing the incidence of IAI. Clinical studies providing reliable evidence regarding the influence of titanium implants on IAI and investigating the susceptibility of titanium to infection are necessary |
| Databáze: | OpenAIRE |
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