Nā huahana

1. Ke piʻi nei ka nui o nā maʻi methicillin-resistant Staphylococcus aureus i loaʻa i ke kaiāulu i kahi wikiwiki weliweli.ʻO ka hoʻomaʻamaʻa maikaʻi ʻana i ka wā kahiko e pili ana i ka debridement mua a me ka hoʻokele antibiotic.Ua hoʻolālā ʻia kēia haʻawina no ka hoʻoholo ʻana i ka pono o ka empiric therapy i ka mālama ʻana i nā maʻi lima.Loaʻa nā maʻi me ka maʻi lima i ka vancomycin intravenous empiric i ke komo ʻana a i ʻole intravenous cefazolin.Ua nānā ʻia nā hopena me ka nui o ka maʻi, ka pane lapaʻau kūpono, a me ka lōʻihi o ka noho ʻana.Ua helu ʻia ke kumukūʻai me ka hoʻohana ʻana i ka huina kālā no kēlā me kēia maʻi ma nā hui ʻelua.Ua hana ʻia nā ʻikepili helu.He iwakāluakūmāhā i koho ʻia i ka cefazolin (52.2 pakeneka) a me 22 (47.8 pakeneka) i vancomycin.ʻAʻohe ʻokoʻa helu ma waena o ke kumukūʻai o ka mālama ʻana (p <0.20) a i ʻole ka lōʻihi o ka noho ʻana (p <0.18) ma waena o nā hui.ʻO nā maʻi i hoʻokaʻawale ʻia i ka cefazolin he kiʻekiʻe aʻe nā kumukūʻai o ka mālama ʻana ma mua o nā maʻi i hoʻokaʻawale ʻia i vancomycin (p <0.05).ʻO nā maʻi me nā maʻi koʻikoʻi ʻoi aku ka nui o ke kumu kūʻai o ka mālama ʻana (p <0.0001) a ʻoi aku ka lōʻihi o ka lōʻihi o ka noho ʻana (p = 0.0002).Ma kahi kokoke i ka pau ʻana o ke aʻo ʻana, ua ʻike ʻia he 72 pakeneka ka nui o ka loaʻa ʻana o ka methicillin-resistant S. aureus i loaʻa i ke kaiāulu ma ka halemai kalana o nā mea kākau, ʻo ia ka mea i hoʻopau mua ʻia ke aʻo ʻana e ka papa loiloi ʻoihana no ka nui o ka nui. ʻAʻole i hoʻokumu paʻa ʻia ka mālama mua ʻana no ka S. aureus kūʻē i ka methicillin.ʻAʻole ʻokoʻa ka hopena i ka hoʻohana ʻana i ka cefazolin versus vancomycin ma ke ʻano he mea hana mua i ʻike ʻia.

2. Me ka hoʻomaikaʻi ʻana i ka hoʻōla ʻana i ka ʻeha ma o ka hoʻohana ʻana i nā antibiotic prophylactic intravenous a me nā hoʻomaʻemaʻe ʻenehana, ua liʻiliʻi nā maʻi kuʻekuʻe postoperative akā aia nō naʻe i kekahi mau ʻoki kuʻekuʻe elective.ʻO ka pahuhopu o kēia noiʻi ʻana, ʻo ia ka loiloi i ka palekana a me ka maikaʻi o ka noi prophylactic o vancomycin i loko o ka wahi hana e hōʻemi ai i ka nui o ka maʻi ma hope o ka wehe ʻana o nā kuʻe lima ʻoʻoleʻa post-traumatic. hana ʻia ka manawa.I loko o ka pūʻulu hoʻomalu (93 mau maʻi), ua hana ʻia ka prophylaxis maʻalahi me nā lāʻau antibiotic intravenous maʻamau;i loko o ka hui vancomycin (179 mau maʻi), ua hoʻopili pololei ʻia ka pauka vancomycin i ka ʻeha ma mua o ka pani ʻana me ka prophylaxis intravenous maʻamau. ka wā: 2.40% -13.52%) i hoʻohālikelike ʻia me ka ʻole (0%; ka wā hilinaʻi: 0-2%.04%) i loko o ka hui vancom ycin, kahi ʻokoʻa nui (P = .0027).ʻAʻole i kākau ʻia nā hopena ʻino mai ka hoʻohana pololei ʻana i ka pauka vancomycin. ʻO ka noi kūloko o ka pauka vancomycin hiki ke lilo i mea hoʻohiki no ka pale ʻana i nā maʻi postoperative elbow ma hope o ka hoʻokuʻu ʻana i ka kuʻekuʻe lima i nā maʻi me ka ʻoʻoleʻa post-traumatic elbow.