Use of an Amikacin-Infused Collagen Sponge Concurrent with Implant Removal for Treatment of TPLO Surgical Site Infection in 30 Cases

2019 ◽  
Author(s):  
S.W. Frederick ◽  
J.N. Forbes ◽  
S.J. Lee ◽  
A.R. Cross
Keyword(s):  
Surgical Site Infection ◽  
Collagen Sponge ◽  
Implant Removal ◽  
Site Infection

scholarly journals Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

2020 ◽  
pp. 219256822097822
Author(s):  
Muyi Wang ◽  
Liang Xu ◽  
Bo Yang ◽  
Changzhi Du ◽  
Zezhang Zhu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Recurrent Infection ◽  
Implant Removal ◽  
Site Infection ◽  
Initial Surgery ◽  
Spinal Deformity Surgery ◽  
Solid Fusion ◽  
Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

scholarly journals Postoperative Management Strategy of Surgical Site Infection following Lumbar Dynesys Dynamic Internal Fixation

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Liehua Liu ◽  
Lei Luo ◽  
Chen Zhao ◽  
Qiang Zhou
Keyword(s):  
Surgical Site Infection ◽  
Internal Fixation ◽  
Management Strategy ◽  
Implant Removal ◽  
Early Infection ◽  
Site Infection ◽  
Infection Site ◽  
Delayed Infection ◽  
Group A ◽  
Group B

Aim. To research the incidence of surgical site infection (SSI) following lumbar Dynesys dynamic internal fixation and its management strategy. Methods. We retrospectively analyzed all cases of lumbar Dynesys dynamic internal fixation performed from January 2010 to December 2019, and the data from patients with SSI were collected. The observational indicators included the incidence of SSI, general information of the patients, surgical details, inflammatory indicators, pathogenic bacteria, and treatment. SSI was defined as both early infection and delayed infection, and the cases were divided into Groups A and B, respectively. The relevant indicators and treatment were compared between the two groups. Results. A total of 1125 cases of lumbar Dynesys dynamic internal fixation were followed up. Twenty-five cases of SSI occurred, and the incidence of SSI was 2.22% (25/1125). There were 14 cases of early infection (1.24%) and 11 cases of delayed infection (0.98%). Fourteen cases of early infection occurred 12.3 ± 8.3 days postoperatively (3–30), and 11 cases of delayed infection occurred 33.3 ± 18.9 months postoperatively (3–62). The inflammatory indicators of Group A were significantly higher than those of Group B (all P < 0.05 ), except for procalcitonin. The main infection site in Group A was located on the skin and subcutaneous tissue and around the internal instrument, while the main infection site in Group B was around the internal instrument. The main treatment for Group A was debridement and implant replacement, and the main treatment for Group B was implant removal. Summary. The incidence of SSI following lumbar Dynesys dynamic internal fixation was 2.22%, the incidence of early SSI was 1.24%, and the incidence of delayed SSI was 0.98%. If the main infection site of early infection is in the incision, debridement should be the main treatment method; if the infection site is around the internal fixation, implant replacement is recommended on the basis of debridement. Once delayed infection is diagnosed, implant removal is suggested.

Outcome following removal of TPLO implants with surgical site infection

2013 ◽  
Vol 26 (04) ◽  
pp. 260-265 ◽  
Author(s):  
B. Beale ◽  
R. Murtaugh ◽  
J. Swiderski-Hazlett ◽  
M. Unis ◽  
R. Savicky
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Medical Management ◽  
Postoperative Infection ◽  
Tibial Plateau ◽  
Clinical Signs ◽  
Implant Removal ◽  
Site Infection ◽  
New Generation ◽  
Postoperative Infection Rate

SummaryObjective To evaluate the outcome of surgical site infection (SSI) associated with tibial plateau levelling osteotomy (TPLO) implants following treatment by medical management alone or implant removal with or without the administration of antibiotic medication.Animals Ninety dogs (104 TPLO surgical procedures).Methods Records of dogs that had undergone TPLO implant removal due to SSI were reviewed. Outcome following treatment with antibiotic medications without implant removal, and treatment with implant removal with and without the administration of antibiotic medications was evaluated.Results Treatment of SSI with antibiotic medication alone failed in 88.9% (64/72) of the dogs. The clinical signs of SSI resolved in 94.9% (74/78) of the dogs treated with implant removal (with and without the administration of antibiotic medication postimplant removal). The effect of administration of antibiotic medication on outcome of treatment of the SSI by implant removal was not significant. The rate of SSI associated with the Synthes implant was higher than with the Slocum implant, but not the New Generation implant.Conclusion Implant removal with or without the administration of antibiotic medication post-implant removal for treatment of TPLO SSI provided superior outcome compared to treatment with antibiotic medications without implant removal.Clinical significance Implant removal should be considered for TPLO SSI that have not responded to appropriate medical management. Further investigation of the various TPLO implants and their effects on postoperative infection rate is warranted.

Risk factors for implant removal after spinal surgical site infection

2017 ◽  
Vol 27 (10) ◽  
pp. 2481-2490 ◽  
Author(s):  
Naoya Tsubouchi ◽  
Shunsuke Fujibayashi ◽  
Bungo Otsuki ◽  
Masanori Izeki ◽  
Hiroaki Kimura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Implant Removal ◽  
Site Infection

Effect of Prophylactic Antibiotics in Orthopaedic Surgery

2021 ◽  
Vol 15 (11) ◽  
pp. 2969-2970
Author(s):  
Muhammad Siraj ◽  
Abbas Ali ◽  
Mudir Khan
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Orthopaedic Surgery ◽  
Prophylactic Antibiotics ◽  
Implant Removal ◽  
Diabetic Patients ◽  
Site Infection ◽  
Post Surgery ◽  
Group 2 ◽  
Group 1

Background: Orthopaedic surgeries require sensitive protocol for prevention of infection pre and post-surgery. Antibiotic-prophylaxis has been reported for reducing risk of infection in orthopaedic surgeries such as removal of implants. Aim: To assess the effect of prophylactic antibiotics in orthopaedic surgery. Study design: Retrospective study Place and duration of study: Dept. of Orthopaedics, Khyber Teaching Hospital, Peshawar from 1-1-2020 to 31-12- 2020. Methodology: One hundred and ten patients within 18-75 years were divided into two groups. Each group had 55 patients. Group 1 were given prophylactic antibiotics pre-operative as a single dose while group 2 were given only saline. All patients were admitted for removal of orthopaedic implants in foot, ankle or leg. Patients 30 days record was observed for any surgical-site infection. Results: The mean age of patient was 42.95±10.8 years. Group 1 and Group 2 had more males than females. There were 10.9% and 9.09% diabetic patients within group 1 and group 2. The 30 days assessment of post implant removal orthopaedic surgery showed a decrease of surgical-site infection in group 1. Surgical-site infection decreased by a rate of 5.4% among patients who were given cefazolin antibiotic. Conclusion: The effect of prophylactic antibiotic reduces chance of surgical-site infection in orthopaedic surgery. Keywords: Antibiotic-prophylaxis, Orthopaedic surgery, Implant-removal, Surgical-site infection

scholarly journals The Use of Gentamicin-Impregnated Collagen Sponge for Reducing Surgical Site Infection after Spine Surgery

2016 ◽  
Vol 13 (3) ◽  
pp. 129 ◽  
Author(s):  
Jin-Sol Han ◽  
Se-Hoon Kim ◽  
Sung-Won Jin ◽  
Seung-Hwan Lee ◽  
Bum-Joon Kim ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spine Surgery ◽  
Collagen Sponge ◽  
Site Infection
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