Infecção De Sítio Cirúrgico Em Osteossíntese De Fêmur: Incidência E Fatores Associados

Vieira, Daiana Aparecida Ribeiro; Cristianismo, Rayana Santos; Campos, Fernanda Fraga; Costa, Magnania Cristiane Pereira da; Lucas, Thábata Coaglio

doi:10.5380/ce.v26i0.76087

Cited by 3 publications

(4 citation statements)

References 17 publications

(52 reference statements)

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“…Therefore, surgical debridement has become more important. 15,17 During subsequent follow up wound was healed and infection subsided. According to Romano classification (Table 1) the fracture was in stage -I post-implant infection, as infection was diagnosed within 2 weeks of initial surgery and not spread to bone.…”

Section: Discussionmentioning

confidence: 95%

“…In femoral fractures infection rate is 4-7% in open and 1-2% in closed cases, 14 and surgical site infection (SSI) in femur fractures are 3.6 to 4.8%. 15 The fracture complexity and soft tissue damage are the critical factors, influence the risk of infection. Thorough clinical evaluation, proper investigations and a specific treatment strategy are the troublesome factors to diagnosis infection after long bone fracture surgery.…”

Section: Discussionmentioning

confidence: 99%

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Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

Rob¹,

Hossain²,

Mustof³

2022

MOJOR

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Introduction: Aim of this study to evaluate the clinical efficacy and highlight their relevance in present orthopedics practice where multiple newer choices have been become famous. Accordion maneuver design with modified Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection place dynamic compression plate (DCP) in situ. Femoral shaft fractures (FSFs) are frequently occurring injury due to RTA. Infection (0.4%) and non-union (1.1 - 14%) are the morbid complications of femur fractures. The healing rate for femora shaft non-unions is too high (90%).1 Accordion Maneuver (AM) is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It comprises of alternate compression and distraction which produce stress in living tissue and also convert biologically inactive scar tissue at non-union site into tissue capable of neo-osteogenesis.2 The suggested treatment for quiescent type of infected non-union is a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ.3 Case Report: In the case, a 26 years man treated by DCP with MIPO for his Gustilo type – Ⅰ open, comminuted fracture of mid femoral shaft (Left) following RTA. Post-operative infection occurred within 2 weeks of operation. Infection controlled by exploration and surgical toileting with antibiotic. After four (4) months later he was sustained re-fractured with bending plate due to fall again. Finally he was diagnosed as H. Rosen`s type 3 Quiescent infected non-union (Oligotrophic) and Romano stage -1 post-implant infection with re-fracture mid shaft of left femur. Then he was treated following accordion principles with modified Ilizarov frame. AM was applied according to protocol of Baruah and Patowary of non-union treatment. Result: After complete union and consolidation, substantiated by radiological evidence Ilizarov apparatus was dispelled six (6) months later of installation without removal of plate and four (4) months of that finally plate was removed. After one (1) year and four (4) months of mounted Ilizarov frame, the patient was in full free movement of knee and hip. He had no problem during walking even running. Conclusion: We pursue for the treatment, accordion maneuver with Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection kept plate in situ. Few authors reported, Accordion Maneuver (AM) techniques with Ilizarov apply over intramedullary nail (IMN) in situ for aseptic non-union of femur. In this study, we discussed the role of this tool (AM) for the treatment of femoral shaft non-union and re-fracture with quiescent infection place plate (DCP) in situ.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

Rob¹,

Hossain²,

Mustof³

2022

MOJOR

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“…The incidence of infection in closed long bones fracture 1-2% and it is higher in open fracture, 5% Gustilo type-I, 10% Gustilo type-II and 15% Gustilo type-III 8 and surgical site infection (SSI) is 3.6 to 4.8%. 9 The fracture complexity and soft tissue damage are the critical factors, influence the risk of infection. Re-fractures are another complication by further trauma where implant failure (Broken, Bending, Loosening) in the region of improper callus formation.…”

Section: Case-i 19 Years Male;mentioning

confidence: 99%

"Accordion maneuver with Ilizarov” Regeneration process in managemet of non-union, hyporegeneration and infection with kept failure implant in situ: a research article

Rob¹,

Hossain²

2023

MOJOR

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Introduction: Accordion Maneuver is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It converts biologically inactive tissue into tissue capable of neo-osteogenesis. The suggested management of non-union, hypo-regeneration and infection with implant failure by a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ. Purpose of the study: Purpose of this study to evaluates the clinical efficacy and highlights their relevance of AM with Ilizarov in present and future orthopedics practice. Methodology: This is a retrospective study of 3 years from 2019 to 2021. Apply AM with Ilizarov in the patient’s management of non-union, hypo-regeneration and infection with implant failure. Patients included ≥18 years, intra-articular fractures are excluded. Total patient 7. Patient`s age from 19-62 years. There were 5 male and 2 female patients. Affected bones were tibia-3, femur-2, humerus-1 and radius & ulna-1. Causes were fall and infection. Final diagnosis was broken implant-2, bending implant with quiescent type infected non-union-1, poly-trauma with broken implant -1 and infection -3. Primary fixation was done by ILIMN in 3 and DCP in 4 cases. We follow Baruah and Patowary suggested protocol of AM in all cases. Summary: After 3-7 months follow up, according to ASAMI score, there were 4 excellent and 3 good outcomes. As per Paley`s classification, in 3 cases found shortening and angulation deformity. We were successfully managed all cases by AM with Ilizarov, kept failure implant in situ. Conclusion: We pursue AM with Ilizarov kept failure implant in situ, as a single stage procedure for the treatment of the patients and found very good results. So, in future it may an ultimate procedure for the management of those helpless conditions.

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“…É importante salientar que 7,2% da amostra não teve registrado no prontuário se foi feito o uso de alguma terapia antibiótica. Na literatura, verificou-se que em Vieira et al (2021), 66,6% dos pacientes notificados fizeram uso de antibióticos, portanto, em 33,4% dos indivíduos não havia registro de uso de antibióticos. Dentre os esquemas terapêuticos utilizados, os mais usados foram: Cefalotina 1g 6/6h por 7 dias endovenoso (EV)…”

Section: Fonte: Autoresunclassified

Análise das infecções de sítio cirúrgico em pacientes ortopédicos de um hospital do Paraná

Longo

Lemos

Vellosa

et al. 2021

RSD

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As infecções de sítio cirúrgico são encontradas em 14-16% dos pacientes hospitalizados, sendo que, as relacionadas a cirurgias ortopédicas são consideradas severas. Portanto, a determinação de fatores de risco, é necessária, pois permite identificar situações que predisponham o desenvolvimento dessa infecção. Com o objetivo de elencar os fatores de riscos relacionados as infecções de sítio cirúrgico em um hospital universitário do Paraná, em um estudo transversal descritivo retrospectivo, foram analisados 125 prontuários de indivíduos submetidos a cirurgias ortopédicas e que desenvolveram a infecção no pós-operatório. Assim, foi possível encontrar um perfil de pacientes mais susceptível a desenvolver essa complicação, na qual, 41,0% dos pacientes foram identificados como saudáveis no pré-operatório, 61,6% das cirurgias tinham um caráter limpo, 63,2% utilizaram implante ortopédico no seu tratamento e o tratamento cirúrgico de fraturas fechadas prevaleceu. A incidência global da infecção foi de 2,0% e os micro-organismos mais prevalentes na amostra foram o Staphylococcus aureus, Enterobacter cloacae e Escherichia coli com 7,2% cada. Comparando-se com a literatura abordada, diferenças são encontradas na prevalência dos fatores de risco, devido às diferenças de cada população. A identificação desses fatores de risco é de suma importância para a prevenção das infecções de sítio cirúrgico. Por fim, novos estudos ainda devem ser realizados com o objetivo de validar os fatores de risco encontrados.

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Infecção De Sítio Cirúrgico Em Osteossíntese De Fêmur: Incidência E Fatores Associados

Cited by 3 publications

References 17 publications

Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

"Accordion maneuver with Ilizarov” Regeneration process in managemet of non-union, hyporegeneration and infection with kept failure implant in situ: a research article

Análise das infecções de sítio cirúrgico em pacientes ortopédicos de um hospital do Paraná

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