1188 Management of Prosthetic Joint Infections and Fracture Related Infections at A District General Hospital

Abstract Aim The aim of our study was to determine if there was cohesion in management of orthopaedic infections between the surgical and microbiology team to ensure optimal patient outcome in accordance with BOA standards for management of Orthopaedic infections. Surgical sampling intraoperatively of orthopaedic infections was evaluated. Method We retrospectively reviewed 19 patients that had suspected PJI or fracture related infections between July 2019 to December 2019 at a District General Hospital. Patient information was collated from patient notes, fusion, bone infection database and MDT notes. Analyses were performed using R (R Foundation for Statistical computing, Vienna, Austria). Results 19/19 patients had a preoperative antibiotic plan prior to index surgery. 0% of discharge summaries contained information for patients or primary care staff regarding management of a suspected orthopaedic infection. 100% of patients who were septic were reviewed by a consultant within 24hours of admission. 72% of patients that had operative intervention had 5 microbiology + 2 histology samples. 0% of patients had surgical recording of process of sampling. All patients were discussed at the newly formed Bone infection MDT with a microbiology consultant, radiologist, and allied health professionals. Conclusions For optimal management of orthopaedic infections an MDT approach is vital. Early microbiological input and appropriate surgical sampling and debridement are key to providing a diagnosis of deep infection. The newly created PJI pathway will aid future management of orthopaedic infections and standardise care.

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COVID-19: Nutrition and functional outcomes for critical care survivors in a 400- bedded district general hospital in North London

Journal of the Intensive Care Society ◽

10.1177/17511437211025420 ◽

2021 ◽

pp. 175114372110254

Author(s):

Rachel Catlow ◽

Charlotte Cheeseman ◽

Helen Newman

Keyword(s):

Critical Care ◽

General Hospital ◽

Health Professionals ◽

Functional Outcomes ◽

Critical Care Unit ◽

Workforce Planning ◽

District General Hospital ◽

Allied Health Professionals ◽

Novel Coronavirus ◽

Rehabilitation Needs

Novel coronavirus disease (COVID-19) has resulted in huge numbers of critically ill patients. This study describes the inpatient recovery and rehabilitation needs of patients admitted with COVID-19 to the critical care unit of a 400 bedded general hospital in London, United Kingdom. The rehabilitation needs of our sample were considerable. It is recommended that the increase demand on allied health professionals capacity demonstrated is considered in future COVID-19-related workforce-planning.

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A 3-year analysis of bacterial isolates from joint infections at a District General Hospital

Journal of Infection ◽

10.1016/j.jinf.2007.04.110 ◽

2007 ◽

Vol 55 (3) ◽

pp. e77

Author(s):

J. Murugesh ◽

G. Priya ◽

C. Molloy ◽

H. Panigrahi

Keyword(s):

General Hospital ◽

District General Hospital ◽

Bacterial Isolates ◽

Joint Infections

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Is ‘Season’ a Risk Factor for Prosthetic Joint Infections?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00105 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0010

Author(s):

Ersin Kuyucu ◽

Engin Çetinkaya ◽

Barış Gülenç ◽

Mehmet Erdil ◽

Yavuz Kocabey

Keyword(s):

Risk Factor ◽

Bacterial Colonization ◽

Waiting Times ◽

Deep Infection ◽

University Hospital ◽

Joint Infections ◽

Prosthetic Joint ◽

First Aid Training ◽

Prosthetic Joint Infections ◽

Arthroplasty Surgery

Background: There are no clear data whether the season of arthroplasty has any demonstrable effect on the emergence of PJI. In the present study we aimed to explore the effect of the season of arthroplasty surgery on the PJI incidence, and to test if season of arthroplasty is a risk factor for PJI. Material & Method: Our study involved 174 (2.5%) patients with superficial and/or deep infection among 6902 patients who underwent arthroplasty procedure at Taksim First Aid Training and Research Hospital, Baltalimanı Bone Hospital and Medipol University Hospital during an approximately 10-year period between January 2006 and June 2015. Results: An analysis of the timing of the surgeries revealed that the first operations were most commonly performed in February (14.4%) and March (13.8%). The season in which most operations were performed was Spring (n=60; 34.5%) whereas Fall had the least number of operations (n=31; 17.8%) There were also no significant monthly or seasonal differences between the number of infections when separate analyses were done for hip joint (n=88) and knee joint replacements (n=86) (p>0.05) Discussion: Despite the lack of a definitive information about the seasonal predilection of prosthetic joint infections, Kane et al showed a significantly increased incidence of infection in summer months among 750 patients operated with arthroplasty, of whom 17 suffered such infection (15). In contrast, among 174 prosthetic joint infections, we found no significant monthly and/or seasonal difference in the incidence of prosthetic joint infections.Increased moisture and temperature increase bacterial colonization both in the outer environment and on the host’s skin, increasing the sensitivity to infections. Perspiration of the host, closed environmental conditions, and increased moisture are other important factors promoting bacterial colonization (16,17). However, appropriate care of the surgical field following surgery is the most important factor reducing bacterial colonization of skin. Another significant problem with arthroplasty surgery is patient satisfaction, which is promoted by as short as possible waiting times from the time of decision to operate to the time of procedure.In conclusion, the incidence of prosthetic joint infections is not increased after arthroplasty operation in summer when bacterial colonization is promoted by increased temperature and moisture. Therefore, season does not appear as a risk factor.

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