One- vs 2-Stage Bursectomy for Septic Olecranon and Prepatellar Bursitis: A Prospective Randomized Trial

被引：7

作者：

Uckay, Ilker ^{[1
,2
,3
]}

von Dach, Elodie ^{[3
]}

Perez, Cedric ^{[1
]}

Agostinho, Americo ^{[1
,3
]}

Garnerin, Philippe ^{[4
]}

Lipsky, Benjamin A. ^{[2
,5
]}

Hoffmeyer, Pierre ^{[1
]}

Pittet, Didier ^{[2
,3
,6
]}

机构：

[1] Univ Geneva Hosp, Orthopaed Surg Serv, Med Econ Control, Geneva, Switzerland

[2] Univ Geneva Hosp, Serv Infect Dis, Med Econ Control, Geneva, Switzerland

[3] Univ Geneva Hosp, Infect Control Program, Med Econ Control, Geneva, Switzerland

[4] Univ Geneva Hosp, Serv Anesthesiol, Med Econ Control, Geneva, Switzerland

[5] Univ Oxford, Med Sci Div, Oxford, England

[6] WHO Collaborat Ctr Patient Safety, Geneva, Switzerland

来源：

MAYO CLINIC PROCEEDINGS | 2017年 / 92卷 / 07期

关键词：

ANTIBIOTIC-THERAPY; PATELLAR BURSITIS; MANAGEMENT; DIAGNOSIS;

D O I：

10.1016/j.mayocp.2017.03.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To assess the optimal surgical approach and costs for patients hospitalized with septic bursitis. Patients and Methods: From May 1, 2011, through December 24, 2014, hospitalized patients with septic bursitis at University of Geneva Hospitals were randomized (1: 1) to receive 1-vs 2-stage bursectomy. All the patients received postsurgical oral antibiotic drug therapy for 7 days. Results: Of 164 enrolled patients, 130 had bursitis of the elbow and 34 of the patella. The surgical approach used was 1-stage in 79 patients and 2-stage in 85. Overall, there were 22 treatment failures: 8 of 79 patients (10%) in the 1-stage arm and 14 of 85 (16%) in the 2-stage arm (Pearson chi(2) test; P = .23). Recurrent infection was caused by the same pathogen in 7 patients (4%) and by a different pathogen in 5 (3%). Outcomes were better in the 1-vs 2-stage arm for wound dehiscence for elbow bursitis (1 of 66 vs 9 of 64; Fisher exact test P = .03), median length of hospital stay (4.5 vs 6.0 days), nurses' workload (605 vs 1055 points), and total costs (Sw. 6881 vs Sw. 11,178; all P<.01). Conclusion: For adults with moderate to severe septic bursitis requiring hospital admission, bursectomy with primary closure, together with antibiotic drug therapy for 7 days, was safe, effective, and resource saving. Using a 2-stage approach may be associated with a higher rate of wound dehiscence for olecranon bursitis than the 1-stage approach. (C) 2017 Mayo Foundation for Medical Education and Research

引用

页码：1061 / 1069

页数：9