Predebridement wound culture in open fractures does not predict postoperative wound infection: A pilot study

Reddy, Lingaraj; Santoshi, John Ashutosh; Devi, Sheela; Najimudeen, Syed; Gnanadoss, James J; Kanagasabai, R; Kanungo, Reba

doi:10.4103/0976-9668.166088

Cited by 15 publications

(4 citation statements)

References 21 publications

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“…Low pressure pulsatile lavage with normal saline is preferred as it has less harmful effects on tissues 27 . The practice of obtaining routine cultures from the wound either pre-or post-debridement is no longer advocated 28 .…”

Section: Irrigation and Debridementmentioning

confidence: 99%

PRINCIPLE OF REHABILITATION & COMPLICATION PREVENTION AFTER MUSCULOSKELETAL TRAUMA

Utomo

Akbar²

2021

JMJ

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Rehabilitation plays a major role to maximize outcome and prevent complications following musculoskeletal trauma and its interventions. It is reported in several studies that mortality risk in patients not receiving rehabilitation was higher compared with patients who received one. The key principles include adequate pain management, anti-infection measures, early ambulation and physical therapy, establishing proper milestones and goals, well-communicated multi-disciplinary approach, and the establishment of standardized and personalized treatment protocol. Early mobilization is supported, as long as wound healing has been taken into consideration. Holistic approach to ensure both physical and psychosocial well-being is recommended, along with special care for geriatric and paediatric populations. Furthermore, alternative medicines such as acupuncture and meditation are currently gaining popularity and subsequently advocated as adjunct therapies.

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Section: Irrigation and Debridementmentioning

confidence: 99%

PRINCIPLE OF REHABILITATION & COMPLICATION PREVENTION AFTER MUSCULOSKELETAL TRAUMA

Utomo

Akbar²

2021

JMJ

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“…En dicho estudio se determinó que la flora inicial no son los mismos organismos infecciosos en las heridas de fractura e440 abierta, y los cultivos de heridas previas al desbridamiento no tienen valor en la infección de la herida posterior al desbridamiento. Por lo tanto, no se recomiendan los cultivos de heridas antes del desbridamiento quirúrgico (16).…”

Section: Cultivo De Heridaunclassified

Manejo de fracturas Abiertas

Méndez

2020

Rev.méd.sinerg.

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Las fracturas abiertas se caracterizan por la pérdida de la continuidad ósea y la exposición del foco de fractura con el medio externo, situación que las hace especialmente vulnerables a procesos infecciosos y múltiples complicaciones. La mayoría de fracturas abiertas son causadas por traumatismos de alta energía; ocurriendo más en hombres y siendo la tibia el hueso que se afecta con mayor frecuencia. Se clasifican según el mecanismo de lesión, la gravedad de lesión de los tejidos blandos, la configuración de la fractura y el grado de contaminación; siendo la más utilizada la clasificación de Gustilo y Anderson por su utilidad terapéutica. Los objetivos principales del tratamiento son prevenir la infección, estabilizar la fractura, conseguir la consolidación y restaurar la función; para ello es indispensable la instauración de una profilaxis antibiótica y un manejo adecuado de los tejidos blandos.

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“…Before 1980, wound bacterial culture was routinely performed before surgical debridement [ 8 , 9 ]. However, recent studies have shown that since the pathogens observed in general wound infections on land are usually acquired in the hospital, wound bacterial culture before debridement for the prediction of wound infection after debridement is not as valuable [ 10 , 11 ]; therefore, cephalosporins are often used in the early stage [ 12 , 13 ]. While the correlation between pathogenicity and seawater bacteria is strong after open trauma following seawater immersion, the correlation with pathogens in the hospital is weaker [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of seawater bacterial infection in rabbit tibia by Illumina MiSeq sequencing and bacterial culture

Wei

Zheng²,

Lv³

et al. 2021

J Orthop Surg Res

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Objectives We aimed to explore the bacterial community composition following ocean bacterial infection using an animal model. Methods This animal-based experiment was conducted from September 2019 to November 2019. Eighteen seawater filter membranes were collected from Changle City, Fujiian Province, China, on September 8, 2019. Ten filter membranes were used for implantation. Eight filter membranes that were used in the bacterial culture for the exploration of seawater bacteria were assigned to the seawater group (SG). Fourteen healthy adult New Zealand rabbits were randomly divided into the experimental group (EG) and control group (CG). Seawater filter membranes and asepsis membranes were implanted into the tibia in the EG and CG, respectively. One week after surgery, tibial bone pathology tissues were collected and assessed using light microscopy and scanning electron microscopy (SEM). Medullary cavity tissues were collected for the performance of Illumina MiSeq sequencing and bacterial culture. The differences between EG and CG were assessed by pathological observation under light microscopy and SEM, high-throughput bacterial sequencing, and bacterial culture. Results Compared with the CG, the infection rate was 100%, and the mortality value was 20% after the implantation of the filter membranes in the EG. Both light microscopy and SEM showed that a large number of bacteria were distributed in the bone marrow cavity after ocean bacterial infection. No bacterial growth was found in the CG. Illumina MiSeq sequencing found that Firmicutes, Proteobacteria, Thermotogae, Fusobacteria, Bacteroidetes, and Actinobacteria were the dominant bacteria at the phylum level and Clostridium_sensu_stricto_7, Haloimpatiens, Clostridium_sensu_stricto_15, Clostridiaceae_1, Clostridium_sensu_stricto_18, and Oceanotoga were the dominant bacteria in genus level among the EG. In the bacterial culture of the medullary cavity tissues, Klebsiella pneumoniae, Shewanella algae, Staphylococcus aureus, Escherichia coli, Enterobacter cloacae, and Vibrio vulnificus were the predominant infective species. Moreover, compared with the SG, the EG showed a higher detection rate of E. coli and S. aureus (P = 0.008 and P = 0.001, respectively). The detection rates of V. alginolyticus, V. parahaemolyticus, and V. fluvialis were higher in the SG than the EG (P = 0.007, P = 0.03, and P = 0.03, respectively). Conclusions Our model, which was comprehensively evaluated using four techniques: histopathology and SEM observation, gene detection, and bacteria culture, provides a scientific basis for the clinical diagnosis and treatment of patients in such settings.

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Predebridement wound culture in open fractures does not predict postoperative wound infection: A pilot study

Cited by 15 publications

References 21 publications

PRINCIPLE OF REHABILITATION & COMPLICATION PREVENTION AFTER MUSCULOSKELETAL TRAUMA

PRINCIPLE OF REHABILITATION & COMPLICATION PREVENTION AFTER MUSCULOSKELETAL TRAUMA

Manejo de fracturas Abiertas

Assessment of seawater bacterial infection in rabbit tibia by Illumina MiSeq sequencing and bacterial culture

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