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E-raamat: Management of Orthopaedic Infections: A Practical Guide

  • Formaat: 190 pages
  • Ilmumisaeg: 22-Apr-2021
  • Kirjastus: Thieme Medical Publishers Inc
  • Keel: eng
  • ISBN-13: 9781638536680
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Management of Orthopaedic Infections: A Practical GuideSuurem pilt
  • Formaat: 190 pages
  • Ilmumisaeg: 22-Apr-2021
  • Kirjastus: Thieme Medical Publishers Inc
  • Keel: eng
  • ISBN-13: 9781638536680
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An evidence-based resource for effectively managing challenging orthopaedic infections

Orthopaedic infections represent common, potentially devastating, and sometimes fatal complications that can occur after any surgery. Infections associated with orthopaedic trauma are especially prevalent, and there is an increasing incidence of bone infections linked to a greater number of joint arthroplasties being performed annually. Management of Orthopaedic Infections: A Practical Guide by renowned orthopaedic surgeon and researcher Antonia Chen is a practical clinical reference to assist clinicians in the diagnosis and treatment of challenging infections spanning the entire orthopaedic specialty.

The step-by-step guide covers frequent organisms found in orthopaedics, molecular methods to improve organism determination, different antibiotic formulations to treat infections, various irrigation solutions used during surgery, and surgical dressings. Ten concise chapters cover surgical management of common infectious pathologies, including osteomyelitis, septic joint, periprosthetic joint infection, open fractures and infected nonunions, spine infections, and graft infections.

Key Features

  • High-quality figures and instructional surgical videos illustrate and enhance understanding of important concepts
  • Multiple tables provide quick references and easy access to salient information needed to manage the care of patients with orthopaedic infections
  • Practical tips from clinicians with vast expertise inform optimal treatment strategies and enable improved outcomes

This is a must-have pocket resource for medical students, residents, fellows, and practitioners in orthopaedic surgery, as well as allied health personnel.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

Videos xi
Foreword xii
Preface xiii
Contributors xiv
1 Detection of Microbes in Orthopaedic Infections
1(17)
Michael Henry
Andy O. Miller
Barry D. Brause
1.1 Introduction
1(1)
1.2 Culture-Based Microbiology
2(8)
1.2.1 Limitations of Culture-Based Microbiology
3(1)
1.2.2 Detection of Microbes in Biofilm
4(1)
1.2.3 Infections with Atypical Organisms
4(1)
1.2.4 Orthopaedic Hardware Infections
5(3)
1.2.5 Native Bone and Joint Infections
8(2)
1.3 Molecular Techniques
10(3)
1.3.1 Polymerase Chain Reaction (PCR)
10(2)
1.3.2 Next-Generation Sequencing (NGS)
12(1)
1.4 Conclusions
13(5)
2 Antibiotics for Orthopaedic Infections
18(16)
Alaina S. Ritter
Sandra B. Nelson
2.1 Systemic Antibiotics
18(7)
2.1.1 Definitions
18(1)
2.1.2 Antibiotic Selection and Administration
19(2)
2.1.3 Intravenous versus Oral Antibiotics
21(4)
2.2 Antiseptics
25(1)
2.2.1 Povidone-lodine
25(1)
2.2.2 Chlorhexidine (Gluconate/Digluconate)
26(1)
2.3 Carriers that may be Associated with Antibiotics
26(1)
23.1 Nondegradable
26(2)
2.3.2 Biodegradable
27(1)
2.4 Antibiotics for Use in Carriers
28(2)
2.4.1 Gentamicin/Tobramycin
30(1)
2.4.2 Vancomycin
30(1)
2.5 Topical Antibiotics
30(1)
2.6 Treatment Failure
30(1)
2.7 Collaboration between Orthopaedic Surgeons and Infectious Disease Specialists
31(1)
2.8 Conclusion
31(3)
3 Irrigation Solutions for Orthopaedic Infections
34(12)
Michael Yayac
Samuel J. Clarkson
Craig Delia Valle
Javad Parvizi
3.1 Acetic Acid
34(2)
3.1.1 Overview of Antiseptic Agents
34(1)
3.1.2 Efficacy as Surgical Wound Irrigant
35(1)
3.2 Bacitracin and Polymyxin
36(1)
3.2.1 Overview of Antiseptic Agent
36(1)
3.2.2 Efficacy as a Surgical Wound Irrigant
36(1)
3.3 Dilute Povidone-lodine (PI)
37(2)
3.3.1 Overview of Antiseptic Agent
37(1)
3.3.2 Efficacy as a Surgical Wound Irrigant
38(1)
3.4 Chlorhexidine
39(1)
3.4.1 Overview of Antiseptic Agent
39(1)
3.4.2 Efficacy as a Surgical Wound Irrigant
40(1)
3.5 Sodium Hypochlorite (NaOCI)
40(1)
3.5.1 Overview of Antiseptic Agent
40(1)
3.5.2 Efficacy as a Surgical Wound Irrigant
41(1)
3.6 Hydrogen Peroxide
41(1)
3.6.1 Overview of Antiseptic Agent
41(1)
3.6.2 Efficacy as a Surgical Wound Irrigant
42(1)
3.7 Conclusion
42(4)
4 Surgical Wound Dressings after Treating Orthopaedic Infections
46(15)
Patrick Moody
Bryan Springer
4.1 Introduction
46(1)
4.2 Characteristics of Optimal Surgical Dressings
47(1)
4.3 Dressing Types
48(9)
4.3.1 Nonocclusive and Occlusive Dressings
48(4)
4.3.2 Dressing Application Tips and Tricks
52(1)
4.3.3 Wound Vacuum Systems
53(4)
4.4 Algorithm for Surgical Dressing Selection
57(1)
4.5 Conclusion
58(3)
5 Osteomyelitis
61(27)
Martin McNally
5.1 Introduction
61(1)
5.2 Terminology
62(2)
5.3 Classification
64(5)
5.3.1 Type 1 (Medullary)
64(2)
5.3.2 Type 2 (Superficial)
66(2)
5.3.3 Type 3 (Localized)
68(1)
5.3.4 Type 4 (Diffuse)
68(1)
5.4 Diagnosis
69(4)
5.4.1 Clinical Features
69(1)
5.4.2 Laboratory Tests
69(1)
5.4.3 Imaging
69(3)
5.4.4 Microbiological Diagnosis
72(1)
5.4.5 Histological Diagnosis
72(1)
5.5 Diagnostic Criteria
73(1)
5.6 Microbiology
73(2)
5.7 Treatment of Osteomyelitis
75(10)
5.7.1 General Considerations
75(2)
5.7.2 Acute Osteomyelitis
77(1)
5.7.3 Chronic Osteomyelitis
77(1)
5.7.4 Operative Treatment
78(1)
5.7.5 Tissue Sampling
79(1)
5.7.6 Tissue Excision
79(2)
5.7.7 Antimicrobial Therapy
81(1)
5.7.8 Dead Space Management
82(1)
5.7.9 Bone Stabilization
82(3)
5.7.10 Soft-Tissue Coverage
85(1)
5.7.11 Staging of Surgery
85(1)
5.8 Conclusion
85(3)
6 Treatment of the Septic Native Joint
88(13)
Timothy L. Tan
Sommer Hammoud
6.1 Introduction
88(1)
6.2 Diagnosis
89(4)
6.2.1 Risk Factors
89(1)
6.2.2 Joint Involvement
90(1)
6.2.3 Clinical Manifestations
90(1)
6.2.4 Serum Evaluation
91(1)
6.2.5 Synovial Analysis
91(2)
6.2.6 Imaging
93(1)
6.3 Treatment
93(5)
6.3.1 Common Organisms
93(1)
6.3.2 Gonococcal Arthritis
94(1)
6.3.3 Other Pathogens
94(1)
6.3.4 Antimicrobial Therapy
94(1)
6.3.5 Surgical Treatment
95(1)
6.3.6 Needle Aspiration
95(1)
6.3.7 Arthroscopic Treatment
95(1)
6.3.8 Open Treatment
96(2)
6.4 Conclusion
98(3)
7 Management of Periprosthetic Joint Infection
101(21)
Malcolm E. Dombrowski
Brian A. Klatt
7.1 Introduction
101(2)
7.2 Chronicity of Infection
103(1)
7.3 Antibiotic Management Alone
104(1)
7.4 Irrigation and Debridement
104(1)
7.4.1 Irrigation and Debridement without Polyethylene Exchange
104(1)
7.5 DAIR
105(2)
7.6 One-Stage Exchange Arthroplasty
107(4)
7.6.1 Preparation
108(1)
7.6.2 Debridement
108(1)
7.6.3 Temporary Closure
109(1)
7.6.4 New Prosthesis Implantation
109(1)
7.6.5 Outcomes of One-Stage Exchange Arthroplasty
110(1)
7.7 Two-Stage Exchange Arthroplasty
111(3)
7.7.1 First Stage: Debridement and Antibiotic Spacer Implantation
111(2)
7.7.2 Second Stage: Reimplantation
113(1)
7.7.3 Outcomes of Two-Stage Exchange Arthroplasty
114(1)
7.8 Salvage Procedures for PJI
114(1)
7.9 Conclusion
115(7)
8 Infection after Fracture Fixation and Infected Nonunions
122(13)
Arvind von Keudell
Michael J. Weaver
8.1 Antibiotic Prophylaxis for Open Fractures
122(2)
8.2 Diagnosis
124(1)
8.2.1 Clinical Diagnosis
124(1)
8.2.2 Laboratory Tests
124(1)
8.3 Imaging
124(4)
8.3.1 Radiography
124(3)
8.3.2 Computed Tomography
127(1)
8.3.3 Magnetic Resonance Imaging
127(1)
8.3.4 Nuclear Medicine Studies
128(1)
8.4 Microbiology
128(1)
8.4.1 Cultures
128(1)
8.4.2 Common Organisms
129(1)
8.5 Surgical Treatment
129(3)
8.5.1 Irrigation Solutions
129(1)
8.5.2 Pin Tract Infections
130(1)
8.5.3 Irrigation and Debridement with Hardware Retention
130(1)
8.5.4 Irrigation and Debridement with Hardware Removal
131(1)
8.5.5 Irrigation and Debridement and Revision Fracture Surgery-One-Stage
131(1)
8.5.6 Irrigation and Debridement with Hardware Removal and Antibiotic Spacer Placement--Two-Stage
131(1)
8.6 Soft-Tissue Coverage
132(1)
8.7 Antibiotics
132(1)
8.8 Conclusion
132(3)
9 Spine Infections
135(16)
Caleb M. Yeung
Melvin C. Makhni
9.1 Spinal Epidural Abscesses
135(5)
9.1.1 Introduction and Epidemiology
135(1)
9.1.2 Anatomy and Pathogenesis
136(1)
9.1.3 Presentation and Diagnosis
136(2)
9.1.4 Management and Surgical Decision-Making
138(2)
9.1.5 Prognosis
140(1)
9.2 Vertebral Osteomyelitis and Diskitis
140(6)
9.2.1 Introduction and Epidemiology--
140(1)
9.2.2 Anatomy and Pathogenesis
141(1)
9.2.3 Presentation and Diagnosis
142(1)
9.2.4 Management and Surgical Decision-Making
143(2)
9.2.5 Prognosis
145(1)
9.3 Conclusion
146(5)
10 Craft Infections
151(20)
Robert Tisherman
Itamar Neto
Orr Limpisvasti
Carola F. van Eck
10.1 Introduction
151(1)
10.2 Risk Factors for Craft Infection
152(3)
10.2.1 The Effect of Graft Type on Rates of Postoperative Infection
152(3)
10.3 Clinical Presentation and Management
155(2)
10.3.1 Clinical Presentation
155(1)
10.3.2 Laboratory Evaluation
156(1)
10.3.3 Surgical Site Infection versus Intra-articular Graft Infection
157(1)
10.3.4 Organisms Responsible for Graft Infection
157(1)
10.4 Management of Craft Infection
157(8)
10.4.1 Nonsurgical Management
157(1)
10.4.2 Surgical Management of Graft Infection
158(4)
10.4.3 Graft Retention
162(1)
10.4.4 Hardware Retention
163(1)
10.4.5 Graft Replantation
163(1)
10.4.6 Antibiotic Management
164(1)
10.5 Outcomes and Complications
165(1)
10.5.1 Recurrent Instability and Reoperation
165(1)
10.5.2 Patient Reported Outcomes Following Graft Infection
165(1)
10.5.3 Graft Infection Cost
165(1)
10.6 Craft Infection Prevention
166(1)
10.6.1 Intraoperative Graft Antibiotics
166(1)
10.7 Intraoperative Autograft Contamination
166(1)
10.8 Conclusion
167(4)
Index 171
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