Bone Health

Summary: Antibiotics are effective in preventing early infection in open fractures of the limbs Wound and bone infections are common complications following open fractures of the limbs. For more than 20 years, in developed countries, the use of antibiotics has been a part of a standard management protocol that also includes irrigation, surgical debridement, and stabilisation when indicated. The review of trials found that antibiotics are effective in decreasing the incidence of wound infections, as compared to no antibiotics or placebo. No studies on bone infection or long-term morbidity were identified. (Cochrane Review)
Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD003764.

From Journal RCSE

Perioperative Prophylactic Antibiotics:
- it is essential that antibiotics be given prior to incision;
- in most cases, patients should receive 1-2 gm of IV Ancef 30 min prior to the incision
Wheeless' Textbook of Orthopaedics

SIGN Publication No. 45 ISBN 1899893 22 9 Published July 2000

Review of post-op wound infections Nigerian Journal of Surgical Research 6(1-2)2004

Pathology & Diagnosis
Prevention & Treatment
Very little available Nov 2008 - OWL Editor

A case of Total Hip Arthroplasty infection with Staphylococcus aureus co-infected with Salmonella choleraesuis was treated with two-stage exchange and administration of vancomycin and ciprofloxacin. No signs of re-infection have appeared 14 months after surgery. Cases of Salmonella infection of hip prostheses are quite rare, with only a handful of reports in the literature.

In the United States, approximately 50,000 knee surgeries are performed each year for repairing anterior cruciate ligament (ACL) injuries (1). Tissue allografts frequently are used for ACL reconstruction, and septic arthritis is a rare complication of such procedures. This report describes four patients who acquired postsurgical septic arthritis probably associated with contaminated bone-tendon-bone allografts used for ACL reconstruction. Effective sterilization methods that do not functionally alter musculoskeletal tissue are needed to prevent allograft-related infections.
MMWR December 7, 2001 / 50(48);1081-3 Full text

In this Review we deal with Surgical Infections requiring surgical intevention and in particular, soft tissue infections.
Soft-tissue infections: Abscess, Cellulitis, Ulcers, Tropical Pyomyositis, Necrotizing Fasciitis, Myonecrosis/Gas Gangrene and Tetanus