Asymptomatic urinary tract colonisation predisposes to superficial wound infection in elective orthopaedic surgery

Ollivere, B.; Ellahee, N.; Logan, Karen; Miller-Jones, J. C. A.; Allen, Paul

doi:10.1007/s00264-008-0573-4

Cited by 57 publications

(51 citation statements)

References 11 publications

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“…The latest work by Gausden et al (5) showed us how the nonunions of the clavicle are very often related to a latent infection and to saprophytic microorganisms of the surgical site (25). Also from the data collected by us we saw that many patients in the preoperative had a high number of comorbidities and postoperatively had dental treatment or infections of other systems that may have been the source of contamination (26)(27)(28). Therefore it is useful, before proceeding to a surgery for a nonunion, to do a careful history and physical examination to discern what type of symptoms and disability, if any, the patient is experiencing.…”

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confidence: 87%

The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem?

Rollo¹

2017

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SummaryIntroduction. The nonunion rate has been reported between 0.1% and 15%. There are also several predisposing factors for the onset of complications: general factors connected with the patient and specific factors related to the fracture site. The purpose of our study is to review the etiology of nonunion of the clavicle in its atrophic form and investigate the outcomes of the revision treatment in a single step. Materials and methods. Retrospective study on 71 patients suffering from nonunions due to the following treatments: conservative in 13 patients; plate fixation in 12; closed reduction and fixation with K-wire in 24; open reduction and fixation with K-wire. All patients were operated on in beach chair position and classic approach to the clavicle by incising the previous surgical scar. The clinical and radiographic criteria for evaluating the outcomes were: the Short Form (12) Health Survey (SF-12), the Constant Shoulder Score (CSS) and the Disability Disabilities of the Arm, Shoulder and Score (DASH) and radiographic Union Score (RUS) for bone healing. The evaluation endpoint was set at 12 months. Results. Blood and culture tests showed 22 infected nonunions and 49 atrophic or oligoatrophic. In only 10 cases, before surgery, the inflammatory markers were positive. The isolated microorganisms were resistant to common antibiotics. In 70 out of 71 cases, plates and screws on the upper side and fibula allogenic splints at the bottom, associated with cancellous bone grafts taken from the patients' iliac crests, were implanted. In one case, however, it was decided to implant the plate on the front edge of the clavicle and the fibula allogeneic splint on the posterior margin, also associated with a cancellous bone graft taken from the patient's iliac crest. The radiographic bone healing was observed in 107.8 (range 82-160) days for the aseptic nonunions, while in 118.4 (range 82-203) days for the septic ones. The non-healing case was a serious failure that led to asubtotal excision of the clavicle. Conclusions. The importance of classification and study of nonunions are essential to achieve positive outcomes. The guiding principle of our work is that aseptic nonunions heal in the operating room, while infected nonunions can be challenged and defeated on the operating table. Restoring the correct length of the clavicle interconnection between the sternum and the shoulder cingulum is indispensable to avoid functional deficits of the upper limb. The fibula splint and the tricorticale bone graft have both mechanical and strong biological values to quickly heal the nonunion.The return to pre-injury quality of life has to be our main goal.

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mentioning

confidence: 87%

The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem?

Rollo¹

2017

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“…[9][10][11][12][13] However, there remains a lack of good evidence that treating asymptomatic bacteriuria reduces the risk of subsequent prosthetic joint infection. Published studies are all small, with insufficient power to generate convincing results.…”

Section: Association Not Causationmentioning

confidence: 99%

Screening for asymptomatic bacteriuria before total joint arthroplasty

Mayne

Davies

Simpson

2016

BMJ

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“…Otro estudio encontró que los pacientes con infección urinaria asintomática detectada por análisis de 59 orina tenían un mayor riesgo de infección de la herida después de la operación, a pesar del tratamiento . No se 43 encontró evidencia sólida que justifique la realización de análisis de orina en pacientes asintomáticos .…”

Section: Exámenes Laboratorialesunclassified

Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo

Estigarribia¹

2015

Rev. virtual Soc. Parag. Med. Int

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Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo Effectiveness of pre-operative studies in healthy patients subjected to low and moderate risk surgeries ResumenIntroducción: los exámenes preoperatorios están indicados según los hallazgos obtenidos en la historia clínica y el examen físico. Se realizan con el propósito de optimizar las condiciones clínicas previas a la cirugía y disminuir las complicaciones perioperatorias. Objetivos: determinar los resultados de exámenes realizados en la evaluación preoperatoria de pacientes sanos sometidos a cirugías de bajo-moderado riesgo y la relación de dichos resultados con las complicaciones perioperatorias. Materiales y métodos: fueron reclutados 113 varones y mujeres menores a 50 años, sanos, admitidos en las salas de Cirugía y de Traumatología del Hospital Nacional (Itauguá) y sometidos a evaluación preoperatoria por la autora en el período de enero a noviembre de 2014. Los estudios evaluados fueron todos solicitados por los médicos tratantes como parte de su rutina. Resultados: los procedimientos quirúrgicos más frecuentes fueron la colecistectomía crónica calculosa y la hernioplastia. El examen laboratorial que reveló más alteraciones fue el hepatograma (15,79%), seguido del hematocrito y la glicemia. En cuanto a la radiografía de tórax y el electrocardiograma, no hubo hallazgos anormales significativos relevantes. Se constató un porcentaje mínimo de complicaciones perioperatorias (5,31%). Conclusión: de todos los estudios realizados en el preoperatorio, se observó por lo menos un resultado anormal en 18,58%. Ningún resultado anormal modificó el manejo perioperatorio ni se relacionó con las complicaciones ocurridas. Palabras claves: evaluación preoperatoria, estudios preoperatorios AbstractIntroduction: The pre-operatory studies are indicated according to the clinical history and clinical examination. They are performed in order to optimize the clinical conditions before a surgery and decrease peri-operative complications. peri-operative complications. Objectives: To determine the results of the studies performed in the pre-operative evaluation of healthy patients subjected to low and moderate risk surgeries and the relationship of these results with the perioperatory complications. Materials and methods: One hundred thirteen healthy men and women younger than 50 years old admitted into the rooms of Surgery and Traumatology of the National Hospital (Itauguá) were subjected to pre-operative evaluation from January to November 2014. The evaluated studies were requested by the treating medical doctors as part of the routine procedure. Results: The most frequent surgical procedures were the chronic calculous cholecystectomy and the hernioplasty. The laboratory exam that revealed most alterations was the hepatogram (15.79%), followed by the hematocrit and the glycemia. In relation to the chest radiograph and the electrocardiogram, there were not significant relevant abnormal findings. A minimum percentage of peri-...

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Asymptomatic urinary tract colonisation predisposes to superficial wound infection in elective orthopaedic surgery

Cited by 57 publications

References 11 publications

The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem?

The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem?

Screening for asymptomatic bacteriuria before total joint arthroplasty

Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo

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