Baertl, Susanne and Rupp, Markus and Alt, Volker (2024) The DAIR-procedure in fracture-related infection-When and how. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 55: 111977. ISSN 0020-1383, 1879-0267
Full text not available from this repository. (Request a copy)Abstract
This narrative review discusses treatment strategies and key considerations guiding decisions in the surgical management of fracture-related infections (FRI). Treatment options primarily revolve around two approaches: debridement antibiotics and implant retention (DAIR), or implant exchange, either in a one or multiple-stage strategy. Several considerations, including time since infection onset, implant type, stability, causative pathogens, host physiology, and soft tissue conditions, inform the choice of surgical intervention for FRI. Current literature supports the preference for a DAIR approach in cases with a short duration of ongoing symptoms, a stable implant with satisfactory fracture reduction, and a viable soft tissue envelope. Conversely, one- or multiple-stage implant exchange is deemed beneficial in instances of compromised local and systemic host physiology, mature biofilm, difficult-to-treat pathogens, intramedullary implants, and cases involving reinfections or failed DAIR procedures. Notably, these recommendations draw parallels from periprosthetic joint infection treatment strategies, constrained by the limited availability of randomized controlled trials comparing these options specifically in acute FRI. In conclusion, future perspectives call for extensive investigations into biofilm maturation and the impact of time on treatment outcomes. Additionally, there is a need for a standardized classification system for FRI to enhance the comparability of treatment outcomes in FRI management.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | IMPLANT RETENTION; FLAP COVERAGE; NONUNION; COMPLICATIONS; EPIDEMIOLOGY; DEBRIDEMENT; BONE; Fracture-related infection; Acute; Surgical therapy; DAIR; Treatment algorithm |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Jan 2026 09:56 |
| Last Modified: | 20 Jan 2026 09:56 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64060 |
Actions (login required)
 |
View Item |
