2022, Vol. 26 ›› Issue (28): 4546-4552

Reducing the recurrence of infection after the application of Masquelet technique for osteomyelitis

Ci Wentao, Zhang Xinlong, Yan Shi, Wang Zhao   

Abstract: BACKGROUND: Masquelet technique is one of the effective methods for the treatment of large segmental bone defects of extremities, especially after debridement of osteomyelitis. The recurrence rate of infection after treatment of osteomyelitis is as high as 10%-15%. How to prevent and reduce infection recurrence is the key to the application of Masquelet technology in the treatment of osteomyelitis.
OBJECTIVE: To explore the key points of how to reduce the recurrence of infection after the application of Masquelet technique in the treatment of osteomyelitis.
METHODS: The relevant articles from January 2010 to March 2021 were searched on PubMed, CNKI and Wanfang databases, with English search term as “Masquelet technique; induced membrane technique; bone infection; osteomyelitis; soft tissue reconstruction; antibiotics; negative pressure wound therapy; debridement”; Chinese search terms were “Masquelet technology; induced membrane technique; bone infection; osteomyelitis; soft tissue reconstruction; antibiotics; negative pressure wound therapy; debridement”. The related contents of how to reduce the recurrence rate of infection after the application of Masquelet technology in the treatment of osteomyelitis were summarized.
RESULTS AND CONCLUSION: The improvement of debridement technique, the optimization of the application of antibiotics, the improvement of local soft tissue reconstruction and the improvement of negative pressure wound therapy are the four main points to reduce the recurrence of infection after osteomyelitis treated by Masquelet technique. The action of targeted antibiotics loaded with antibiotic carriers on the focus of infection can effectively improve the bacteriostasis of local antibiotics. How to accurately regulate the local antibiotic release curve to cope with the change of local bacterial load at different times is the direction that scholars need to further study in the future. Reducing the effect of high antibiotic release on the biological properties of induced membrane, the combined application of antibiotic carrier technology and induced membrane technology is the research focus of Masquelet technology in the treatment of osteomyelitis in the future.
Key words: Masquelet technique, osteomyelitis, infection recurrence, antibiotics, debridement, soft tissue reconstruction, negative pressure wound therapy