Diagnosis and treatment of infections associated with fracture-fixation devices

Trampuž, Andrej; Zimmerli, Werner

doi:10.1016/j.injury.2006.04.010

Cited by 497 publications

(415 citation statements)

References 37 publications

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“…In our case-control study, remission rates of combined surgical and medical treatment of established implant infections after fracture management (128/139, 92 %) were significantly higher than for the treatment of chronic osteomyelitis [7] or arthroplasties [9,10], with remission rates ranging between 75 and 90 % in the literature [4]. Our remission rate is also higher than the 73 % published regarding young healthy individuals with ankle fractures [14] or the 72 % among 25 early staphylococcal infections following rigid internal fixation [9].…”

Section: Discussionmentioning

confidence: 57%

“…The adequate administration route and the duration of antibiotic agents in implant infections are not based on randomised trials or other forms of evidence. They rely on expert opinion with some indirect information from past animal studies or in vitro experiments [3,4]. Traditionally, a six-to 12-week course of antibiotic therapy is recommended [5,9,10,13,16], of which the first two to four weeks are usually given intravenously [1,11].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, surprisingly little has been published concerning the success of their treatment [1]. Expert recommendations pertain to other osteoarticular infections and advocate at least one surgical drainage, implant removal if feasible and concomitant antibiotic therapy until osseous consolidation or for six weeks post implant removal [2][3][4]. This is the case even though implant-associated infections are conceptually different from other orthopaedic infections.…”

Section: Introductionmentioning

confidence: 99%

“…We think that antibiotic therapy concomitant with surgery might be significantly reduced to some few weeks in an oral form. We did not address risk factors for infection occurring after primary osteosynthesis [4] or the incidence of infections after elective implant removal for mechanical reasons.…”

Section: Introductionmentioning

confidence: 99%

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Remission rate of implant-related infections following revision surgery after fractures

Al-Mayahi

Betz

Müller

et al. 2013

International Orthopaedics (SICOT)

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Purpose In contrast to a large amount of epidemiological data regarding the incidence of implant infections after fracture management, surprisingly few have been published concerning the success of their treatment. Methods This was a single-centre cohort study at Geneva University Hospitals from 2000 to 2012 investigating the remission rates of orthopaedic implant infections after fracture repair and associated variables. Results A total of 139 episodes were included: There were 51 women (37 %) and 28 immunosuppressed (20 %) patients with a median age and American Society of Anaesthesiologists (ASA) score of 51 years and 2 points, respectively. The infected implants were plates (n =75, 54 %), nails (24, 17 %), wires (20), screws (10), cerclage cables or wires (3), hip screws (4) or material for spondylodesis (3). A pathogen was identified in 135 (97 %) cases, including Staphylococcus aureus (73, 52 %), coagulase-negative staphylococci (20), streptococci (7) and 19 Gram-negative rods. All patients underwent antibiotic treatment, and 128 (92 %) remained in remission at a median follow-up time of 2.6 years (range one to 13 years). In multivariate logistic regression analysis, the plate infections were significantly associated with lower remission rates [65/75, 87 %, odds ratio ( Conclusions Among all infected and removed orthopaedic implants, plates were associated with slightly lower remission rates, while the overall treatment success exceeded 90 %. The duration of antibiotic therapy did not alter the outcome.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Remission rate of implant-related infections following revision surgery after fractures

Al-Mayahi

Betz

Müller

et al. 2013

International Orthopaedics (SICOT)

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“…A patogênese de infecções em cirurgias de implantes ortopédicos e osteossínteses é influenciada pela capacidade de formação do biofilme pelos microrganismos responsáveis, com uma suscetibilidade diminuída aos antibióticos, destacando-se o S. aureus e S. epidermidis 11,12 .…”

Section: Staphylococcus Aureusunclassified

Contaminação do ar em salas cirúrgicas durante cirurgias de artroplastias total de quadril e joelho, hemiartroplastias e osteossínteses no centro cirúrgico de um hospital Brasileiro

Dolinger

Brito

Souza

et al. 2010

Rev. Soc. Bras. Med. Trop.

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INTRODUÇÃO: Avaliou-se o nível da contaminação do ar em cirurgias ortopédicas. MÉTODOS: O ar das salas cirúrgicas foi analisado microbiologicamente através da exposição de placas próximas à mesa cirúrgica por uma hora. RESULTADOS: Foram evidenciados valores acima do recomendado (369 UFC/m³) nas salas convencionais, assim como naquelas com ar ultralimpo. A contaminação foi predominantemente por Staphylococcus sp (86,9%). verificou-se um número alto de pessoas presentes no interior das salas cirúrgicas, assim como de abertura da porta. CONCLUSÕES: Os níveis de contaminação se apresentaram acima dos valores aceitos por agências reguladoras, representando risco para os pacientes.

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Antibiotics for treating chronic osteomyelitis in adults

Conterno

Turchi

2013

Cochrane Database of Systematic Reviews

174

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Limited and low quality evidence suggests that the route of antibiotic administration (oral versus parenteral) does not affect the rate of disease remission if the bacteria are susceptible to the antibiotic used. However, this and the lack of statistically significant differences in adverse effects need confirmation. No or insufficient evidence exists for other aspects of antibiotic therapy for chronic osteomyelitis.The majority of the included trials were conducted over 20 years ago and currently we are faced with a far higher prevalence of bacteria that are resistant to many of the available antibiotics used for healthcare. This continuously evolving bacterial resistance represents another challenge in the choice of antibiotics for treating chronic osteomyelitis.

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Diagnosis and treatment of infections associated with fracture-fixation devices

Cited by 497 publications

References 37 publications

Remission rate of implant-related infections following revision surgery after fractures

Remission rate of implant-related infections following revision surgery after fractures

Contaminação do ar em salas cirúrgicas durante cirurgias de artroplastias total de quadril e joelho, hemiartroplastias e osteossínteses no centro cirúrgico de um hospital Brasileiro

Antibiotics for treating chronic osteomyelitis in adults

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