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您的检索式：作者名="Vishal Hegde"
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| 1 | Management of postoperative spinal infections显示文摘Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories:(1) microbiological factors;(2) factors related to the patient and their spinal pathology; and(3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique,prophylactic antibiotics,avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinalinstrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure. | Vishal Hegde Dennis S Meredith Christopher K Kepler Russel C Huang | 2012 | World Journal of Orthopedics2012，3，11： | 17 |
| 2 | Evading the host response:Staphylococcus“hiding”in cortical bone canalicular system causes increased bacterial burden显示文摘Extremity reconstruction surgery is increasingly performed rather than amputation for patients with large-segment pathologic bone loss.Debate persists as to the optimal void filler for this“limb salvage”surgery,whether metal or allograft bone.Clinicians focus on optimizing important functional gains for patients,and the risk of devastating implant infection has been thought to be similar regardless of implant material.Recent insights into infection pathophysiology are challenging this equipoise,however,with both basic science data suggesting a novel mechanism of infection of Staphylococcus aureus(the most common infecting agent)into the host lacunar–canaliculi network,and also clinical data revealing a higher rate of infection of allograft over metal.The current translational study was therefore developed to bridge the gap between these insights in a longitudinal murine model of infection of allograft bone and metal.Real-time Staphylococci infection characteristics were quantified in cortical bone vs metal,and both microarchitecture of host implant and presence of host immune response were assessed.An orders-of-magnitude higher bacterial burden was established in cortical allograft bone over both metal and cancellous bone.The establishment of immune-evading microabscesses was confirmed in both cortical allograft haversian canal and the submicron canaliculi network in an additional model of mouse femur bone infection.These study results reveal a mechanism by which Staphylococci evasion of host immunity is possible,contributing to elevated risks of infection in cortical bone.The presence of this local infection reservoir imparts massive clinical implications that may alter the current paradigm of osteomyelitis and bulk allograft infection treatment. | Stephen D.Zoller Vishal Hegde Zachary D.C.Burke Howard Y.Park Chad R.Ishmael Gideon W.Blumstein William Sheppard Christopher Hamad Amanda H.Loftin Daniel O.Johansen Ryan A.Smith Marina M.Sprague Kellyn R.Hori Samuel J.Clarkson Rachel Borthwell Scott I.Simon Jeff F.Miller Scott D.Nelson Nicholas M.Bernthal | 2020 | Bone Research2020，8，4： | 0 |
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