General Principles of Infection

Cleveland, Kevin B.

doi:10.1016/b978-0-323-03329-9.50018-0

Cited by 4 publications

(3 citation statements)

References 175 publications

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“…Recognising the distinctive physiologic and anatomic characteristics of bone infections, prevention is the best course of action. Wound care is an important surgeon-dependent risk factor for infection besides prophylactic antibiotics, operating room environment and surgical technique [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Honey dressing: a missed way for orthopaedic wound care

Ahmed

Eltregy

Kandil

2022

International Orthopaedics (SICOT)

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Purpose Orthopaedic-related wounds are critical situations calling for care to avoid deep infections and its consequences. The purpose of this study was to evaluate the efficacy of using honey for care of orthopaedic-related wounds with limited resources. Patients and methods This prospective study included 50 cases with an average age of 38.18 (range 17–63) years with 38 males and 12 females. The most frequent wound location was the leg (41 patients; 82%), then the foot (six patients; 12%), and the ankle in three patients (6%). The aetiologies were open fractures (34 cases; 68%), infected tibial non-unions (nine cases; 18%), and post-operative infections (seven cases; 14%). Exposed tendon was present in three cases. Bone exposure was present in two cases. Deep infection was present in 29 cases (58%). Besides treating the primary cause, a ribbon of gauze soaked with honey was applied to the wounds after thorough saline washing. Results Wound sizes were variable. All cases showed improvement in all parameters with complete wound healing and full coverage of bone and tendons. Recurrence of deep infection occurred in three cases and treated by debridement. One case needed sequestrectomy of a small exposed tibial cortical fragment. Exposed tendon cases showed superficial necrosis which was treated by simple debridement. Initial mild itching occurred in five patients with spontaneous resolution. Conclusion With treating the underlying aetiology and optimising the patient’s general condition, honey was an effective, simple, and affordable method of wound care in different orthopaedic conditions even with exposed bone or tendons.

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Section: Introductionmentioning

confidence: 99%

Honey dressing: a missed way for orthopaedic wound care

Ahmed

Eltregy

Kandil

2022

International Orthopaedics (SICOT)

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“…15 This can be done by using PALACOS instead of PMMA which has been shown to have better antibiotic elution into the surrounding tissue. The elution of antibiotic is up to 3 cm only 21 and depends on the local environment. So, it is necessary to place cement rods or beads as close as possible to the infected area.…”

Section: Discussionmentioning

confidence: 99%

A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones

Bharti

Saroj²,

Kumar

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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“…[2] Therapeutic failure may occur in bone infections due to avascular sequestrum, making preventive measures mandatory. [3]…”

Section: Introductionmentioning

confidence: 99%

Appropriateness and pharmacoeconomics of surgical antimicrobial prophylaxis in open reduction internal fixation surgery practiced in a tertiary hospital compared to recommendations in the national center for disease control guidelines

2019

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Context:Surgical site infections are frequently observed despite the availability of national guideline on surgical antimicrobial prophylaxis (SAP). These infections increase patient morbidity, mortality, and direct and indirect health-care costs. Open reduction internal fixation (ORIF) is a common orthopedic surgery for fracture. There is a paucity of Indian data on SAP in ORIF surgery.Aims:The present study was taken up aiming at the evaluation of appropriateness and pharmacoeconomics of SAP in ORIF based on the national guidelines.Subjects and Methods:One-year observational prospective cohort study was conducted among 412 participants, who underwent ORIF in the Department of Orthopedics in a Tertiary Care Hospital. Name, dose, route, timing, frequency, and duration of administration of prophylactic antimicrobials used were recorded.Statistical Analysis Used:Descriptive statistics were used wherever required.Results:The mean age of participants was 39.24 years, majority (60.92%) were male, and 49.52% had fracture of lower-limb bones. The appropriateness of preoperative SAP in terms of indication in ORIF, timing, and route of administration was 100%. Selection and dose of preoperative and postoperative antimicrobials were appropriate in only 13% of cases. Omission of intraoperative dose was appropriate in all participants. Duration of postoperative Antimicrobial agent administration was inappropriately long in all participants. None of the cases received completely appropriate regimen. Cost analysis showed the mean cost of SAP practiced in our hospital was eleven times higher than that with recommended SAP.Conclusions:Considering the inappropriateness of SAP practiced, monitoring of guideline implementation and awareness among health-care professionals are necessary to prevent SSI and to decrease economic burden on the patients.

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General Principles of Infection

Cited by 4 publications

References 175 publications

Honey dressing: a missed way for orthopaedic wound care

Honey dressing: a missed way for orthopaedic wound care

A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones

Appropriateness and pharmacoeconomics of surgical antimicrobial prophylaxis in open reduction internal fixation surgery practiced in a tertiary hospital compared to recommendations in the national center for disease control guidelines

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