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Orthopedic infection control

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https://www.readbyqxmd.com/read/28645704/reconstruction-of-large-diaphyseal-bone-defect-by-simplified-bone-transport-over-nail-technique-a-7-case-series
#1
F Ferchaud, L Rony, F Ducellier, P Cronier, V Steiger, L Hubert
INTRODUCTION: Reconstruction of large diaphyseal bone defect is complex and the complications rate is high. This study aimed to assess a simplified technique of segmental bone transport by monorail external fixator over an intramedullary nail. MATERIAL AND METHOD: A prospective study included 7 patients:2 femoral and 5 tibial defects.Mean age was 31 years (range, 16-61 years). Mean follow-up was 62 months (range, 46-84 months). Defects were post-traumatic, with a mean length of 7...
June 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28629079/silver-doped-resorbable-tricalcium-phosphate-scaffolds-for-bone-graft-applications
#2
Sean Hoover, Solaiman Tarafder, Amit Bandyopadhyay, Susmita Bose
Bone graft procedures, in particular maxillofacial repair, account for half of the orthopedic procedures done in the US each year. Infection is a major issue in surgery, and should be of primary concern when engineering biomaterials. Silver is of renewed importance today, as it has the ability to potentiate antibiotics against resistant bacterial strains. In order to reduce long term infection risks, it is necessary for the scaffold to maintain a silver ion release for the length of the healing process. In this study, silver doped porous β-tricalcium phosphate (β-TCP) scaffolds were engineered using liquid porogen based method with the goal of meeting these requirements...
October 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28622340/antibiotic-prophylaxis-for-surgical-site-infections-as-a-risk-factor-for-infection-with-clostridium-difficile
#3
Aubrey Balch, Aaron M Wendelboe, Sara K Vesely, Dale W Bratzler
OBJECTIVE: We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile. DESIGN: We conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013. SETTING: Large urban community hospital. PATIENTS: Cases and controls were patients age 18+ years who underwent an eligible surgery (i...
2017: PloS One
https://www.readbyqxmd.com/read/28606258/-meta-analysis-of-the-efficacy-and-safety-of-drainage-after-total-hip-arthroplasty
#4
N Hou, F Jing, W Rong, D W He, J J Zhu, L Fang, C J Sun
Objective: To determine whether suction drainage is safe and effective compared with no-drainage in total hip arthroplasty. Methods: The research was based on PubMed, MEDLINE, EMBASE, Highwire, the Cochrane Library, CBM, CNKI, VIP and WFSD.The data were analysed using RevMan 5.2.Twenty-seven randomised controlled trials involving 3 603 hips were included in the analysis. Results: The meta-analysis indicate that suction drainage increases the rate of homologous blood transfusion (OR=1.98, 95%CI: 1.49-2.64, P<0...
June 6, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28594999/regenerating-bone-via-multifunctional-coatings-the-blending-of-cell-integration-and-bacterial-inhibition-properties-on-the-surface-of-biomaterials
#5
Mireia Hoyos-Nogués, Ferran Velasco, Maria-Pau Ginebra, José María Manero, F Javier Gil, Carlos Mas-Moruno
In dentistry and orthopedics, it is well accepted that implant fixation is a major goal. However, an emerging concern is bacterial infection. Infection of metallic implants can be catastrophic and significantly reduce patient quality of life. Accordingly, in this work, we focus on multifunctional coatings to simultaneously address and mitigate both these problems. We have developed a tailor-made peptide-based chemical platform that integrates the well-known RGD cell adhesive sequence and the lactoferrin-derived LF1-11 antimicrobial peptide...
June 21, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#6
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28578841/povidone-iodine-based-solutions-for-decolonization-of-nasal-staphylococcus-aureus-a-randomized-prospective-placebo-controlled-study
#7
Maryam Rezapoor, Thema Nicholson, Reza Mostafavi Tabatabaee, Antonia F Chen, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Nasal Staphylococcus aureus decolonization reduces the risk of surgical site infections after orthopedic procedures. Povidone-iodine (PI)-based solutions have shown promising results in bacteria decolonization. The unique physiology of the nose may pose challenges for the bioactivity profiles of PI solutions. This study compared the antibacterial efficacy of an off-the-shelf PI product with a specifically manufactured PI-based skin and nasal antiseptic (SNA). METHODS: This randomized, placebo-controlled study was conducted at a single institution between April 2014 and July 2015...
May 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28575938/tailor-made-alginate-hydrogel-for-local-infection-prophylaxis-in-orthopedic-applications
#8
K Sangeetha, E K Girija
Preventing implants associated infections is crucial in orthopedics. Local delivery of antibiotics through implants is a promising strategy to solve this issue. In this study, alginate is tailored to control its swelling, entrapment and release of ciprofloxacin (antibiotic) through the formation of interpenetrating polymer network and composite matrices using gelatin and hydroxyapatite. Developed matrices were characterized by Fourier transform infrared spectroscopy, x-ray diffraction and scanning electron microscopy...
September 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28573554/-prevention-of-postoperative-infections-risk-factors-and-the-current-who-guidelines-in-musculoskeletal-surgery
#9
REVIEW
Christian Willy, Hayo Rieger, Marcus Stichling
BACKGROUND: Despite the many scientific and technological advances postoperative infection continues to be a large problem for trauma and orthopedic surgeons. Based on a review of the current literature, this study provides a comprehensive overview of the risk factors (RF) and possible preventive measures to control surgical site infections. METHODS: Medline search and analysis from 1968-2017 (as of 01 March 2017). Selection of trauma and orthopedic relevant RFs and comparison with WHO recommendations (global guidelines for the prevention of surgical site infection, Nov...
June 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28566785/combined-negative-pressure-wound-therapy-with-open-bone-graft-for-infected-wounds-with-bone-defects-an-experimental-study
#10
Ramesh Kumar Jha, Chengyan Xia, Zonghuan Li, Weiyang Wang, Kai Deng
BACKGROUND: Bone and soft-tissue defects in infected wound have been an intractable problem to many surgical consultations. Infected wounds with bone defects are physical and financial burden to society. Nowadays, infected wounds with compound defect of bone and soft tissues are common in orthopedics department. Currently, no simple and efficient treatment has been found to solve this problem. This study investigates the effects of combining negative pressure wound therapy (NPWT) with open bone graft on this focus...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28566781/a-comparative-study-of-intramedullary-interlocking-nailing-and-minimally-invasive-plate-osteosynthesis-in-extra-articular-distal-tibial-fractures
#11
Arup K Daolagupu, Ashwani Mudgal, Vikash Agarwala, Kaushik K Dutta
BACKGROUND: Extraarticular distal tibial fractures are among the most challenging fractures encountered by an orthopedician for treatment because of its subcutaneous location, poor blood supply and decreased muscular cover anteriorly, complications such as delayed union, nonunion, wound infection, and wound dehiscence are often seen as a great challenge to the surgeon. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods, but each has been historically related to complications...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28552898/sustained-release-vancomycin-coated-titanium-alloy-using-a-novel-electrostatic-dry-powder-coating-technique-may-be-a-potential-strategy-to-reduce-implant-related-infection
#12
Jing Han, Yi Yang, Junren Lu, Chenzhong Wang, Youtao Xie, Xuebin Zheng, Zhenjun Yao, Chi Zhang
In order to tackle the implant-related infection, a novel way was developed in this study to coat vancomycin particles mixed with controlled release coating materials onto the surface of titanium alloy by using an electrostatic dry powder coating technique. To characterize this sustained release antibacterial coating, surface morphology, in vitro and in vivo drug release were sequentially evaluated. In vitro cytotoxicity was tested by Cell Counting Kit-8 (CCK-8) assay and cytological changes were observed by inverted microscope...
May 26, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28549361/-leukocyte-esterase-as-a-diagnostic-tool-for-an-infectious-disease-of-the-knee
#13
S U Ceja-Picazo, S Fuentes-Figueroa, A H Rivera-Villa, A R Hernández-Salgado, R Torres-González, A M Pérez, J A Hernández-García, J M Pérez-Atanasio
BACKGROUND: Articular infection is an orthopedic challenge due to its difficult diagnosis and devastating results. Various diagnostic studies exist: culture, ESR, CRP, count of leukocytes, among others, but none is specific, they all take more than 30 minutes to complete, and require complex infrastructure. In this study, we determine the sensitivity and specificity of the leukocyte esterase for detection of an infectious process joint in Mexican population. MATERIAL AND METHODS: During November 2015 to April 2016, we obtained synovial fluid from two groups of patients: one with a diagnosis of synovial joint infection with or without implant, and the control group, without infection but with degenerative pathology of the knee...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28548484/controlled-release-of-naringin-in-metal-organic-framework-loaded-mineralized-collagen-coating-to-simultaneously-enhance-osseointegration-and-antibacterial-activity
#14
Mengfei Yu, Dongqi You, Junjun Zhuang, Suya Lin, Lingqing Dong, Shengtao Weng, Bin Zhang, Kui Cheng, Wenjian Weng, Huiming Wang
Two important goals in orthopedic implant research are to promote osseointegration and prevent infection. However, much previous effort has been focused on the design of coatings to either enhance osseointegration while ignoring antibacterial activity or vice versa, to prevent infection while ignoring bone integration. Here, we designed a multifunctional mineralized collagen coating on titanium with the aid of metal-organic framework (MOF) nanocrystals to control the release of naringin, a Chinese herbal medicine that could promote osseointegration and prevent bacterial infection...
June 5, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28537526/composite-biomaterial-as-a-carrier-for-bone-active-substances-for-metaphyseal-tibial-bone-defect-reconstruction-in-rats
#15
Peter Frederik Horstmann, Deepak Raina, Hanna Isaksson, Werner Hettwer, Lars Lidgren, Michael Mørk Petersen, Magnus Tägil
Restoring lost bone is a major challenge in orthopedic surgery. Currently available treatment-strategies all have shortcomings, like risk of infection, non-union and excessive resorption. Our primary aim was to study if a commercially available gentamicin-containing composite calcium sulphate/hydroxyapatite biomaterial (GBM) could serve as a carrier for local delivery of bone morphogenic protein-2 (BMP-2) and zoledronic acid (ZA) in a tibia defect-model in rats. Empty and allograft-filled defects were used as controls...
May 24, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28532076/sustained-drug-release-from-surface-modified-uhmwpe-for-acetabular-cup-lining-in-total-hip-implant
#16
R Manoj Kumar, Pallavi Gupta, Sandan Kumar Sharma, Akshat Mittal, Manish Shekhar, Vijayesh Kumar, B V Manoj Kumar, Partha Roy, Debrupa Lahiri
Despite sterilization and aseptic procedure, bacterial infection remains a key challenge in total hip arthroplasties. This fact emphasizes the urgent need for development of new implant systems, which should releases the drug in a controlled manner without sparing its mechanical and tribological properties. In this study, the lining material of the acetabular cup, in total hip implant, has been modified for sustained release of drugs, which should be available throughout the site of implantation to fight the post-operation bacterial infection...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28487001/effect-of-medicare-s-nonpayment-policy-on-surgical-site-infections-following-orthopedic-procedures
#17
Jereen Z Kwong, Yingjie Weng, Micaela Finnegan, Robyn Schaffer, Austin Remington, Catherine Curtin, Kathryn M McDonald, Jay Bhattacharya, Tina Hernandez-Boussard
OBJECTIVE Orthopedic procedures are an important focus in efforts to reduce surgical site infections (SSIs). In 2008, the Centers for Medicare and Medicaid (CMS) stopped reimbursements for additional charges associated with serious hospital-acquired conditions, including SSI following certain orthopedic procedures. We aimed to evaluate the CMS policy's effect on rates of targeted orthopedic SSIs among the Medicare population. DESIGN We examined SSI rates following orthopedic procedures among the Medicare population before and after policy implementation compared to a similarly aged control group...
May 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28448706/-prognostic-factors-for-post-surgical-complications-in-bone-infection-and-pseudarthrosis
#18
A Cicero-Álvarez, S R León-Hernández, K Gutiérrez-Enríquez, S Zapata-Rivera
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28448204/future-research-opportunities-in-peri-prosthetic-joint-infection-prevention
#19
Elie Berbari, John Segreti, Javad Parvizi, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28434696/complete-eradication-of-biofilm-from-orthopedic-materials
#20
Jeffrey T Leary, Matthew M Werger, William H Broach, Lindsey N Shaw, Brandon G Santoni, Thomas L Bernasek, Steven T Lyons
BACKGROUND: Interest exists in finding alternatives to current management strategies in periprosthetic joint infections, which typically include a 2-stage revision with placement of an antibiotic spacer and delayed placement of a new implant. We studied the efficacy of autoclaving, ultrasonication, and mechanical scrubbing for sterilization and biofilm eradication on infected cobalt-chrome discs. METHODS: Strains of Staphylococcus aureus MRSA252 or Staphylococcus epidermidis RP62A were grown on the discs...
March 29, 2017: Journal of Arthroplasty
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