Management of Chronic Deep Infection Following Rotator Cuff Repair*

Mirzayan, Raffy; Itamura, John M.; Vangsness, C. Thomas; Holtom, Paul; Sherman, Randy; Patzakis, Michael J.

doi:10.2106/00004623-200008000-00008

“…The incidence of infection after rotator cuff repair ranges between 0.27% to 1.9% [3,18,27,28,37], whereas the incidence after shoulder arthroplasty ranges from 0% and 15.4% [9,11,38,41,44]. Infections after proximal humerus fractures are less common [4,29,32,40,46].…”

Section: Introductionmentioning

confidence: 99%

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Millett

¹

,

Yen

²

,

Price

³

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…In these patients, the use of a muscle to cover the wound and fill the dead space can help provide a better seal for improved wound healing and infection control [31]. Previously reported flaps used for local coverage of deep shoulder wounds following rotator cuff repair include the latissimus dorsa and pectorals major, both of which have been reported to have favourable outcomes [29][30][31].…”

Section: Resultsmentioning

confidence: 99%

“…In these patients, the use of a muscle to cover the wound and fill the dead space can help provide a better seal for improved wound healing and infection control [31]. Previously reported flaps used for local coverage of deep shoulder wounds following rotator cuff repair include the latissimus dorsa and pectorals major, both of which have been reported to have favourable outcomes [29][30][31]. Modern reconstructive literature indicates that utilization of well vascularized fasciocutaneous flaps is equivalent to use of a muscle flap for wound coverage, and the choice of the regional flap is at the discretion of the reconstructive surgeon [32][33][34][35][36].…”

Section: Resultsmentioning

confidence: 99%

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The Use of Regional Flaps for the Repair of Synovio-Cutaneous Fistulas of the Shoulder after Attempted Rotator Cuff Repair: A Report of Two Cases

Rl¹,

Kj²,

Nl³

et al. 2016

Bone Rep Recommendations

0

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Context: The treatment of rotator cuff tears has become one of the most common orthopaedic sports procedures. The development of a synovio-cutaneous fistula is a rare, but serious, complication that has been described after rotator cuff repair. The purpose of this report is to present the local rotational flap as a treatment option for synovio-cutaneous fistulas of the shoulder and to emphasize the importance of recognizing when primary closure may not be sufficient for adequate repair.Case Reports: A 67-year-old male who previously underwent a right rotator cuff and a biceps tendon repair presented with a persistently draining shoulder fistula. The decision was made to proceed with extensive debridement and closure using vascularized tissue. A 63-year-old male presented for a postoperative wound complication following attempted open debridement of a left torn rotator cuff. The wound was initially managed conservatively, but a persistently draining fistula necessitated the use of vascularized tissue for closure of the wound. The recovery of both patients was uneventful with no recurrent fistula formation. Both patients had improved shoulder range of motion following surgery and resolution of their pain. Conclusions:The excessive tension placed on the rotator cuff tendons and deltoid during repair and the resultant inflammation may contribute to tissue necrosis and facial dehiscence over the glen humeral joint, allowing for fistula formation. Surgeons should be aware that when adequate soft tissue coverage cannot be accomplished over the glen humeral joint via primary closure, there are local flaps available to provide complete coverage over the joint.

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“…Tüm omuz artroskopisi teknikleri arasında en sık rotator manşet cerrahisi sonrası enfeksiyon bildirilmiştir. İle-ri yaş, hipotiroidizm, diabetes mellitus, sigara ve alkol kullanımı, sterilizasyona bağlı sorunlar ve uzamış cerrahi süre risk faktörleri arasındadır (47,48) . En sık görülen bakteriler Staphylococcus aureus, koagülaz negatif stafilokoklar ve Proprionobacterium acnestir (49) .…”

Section: Enfeksiyonunclassified

Review: Complications of Rotator Cuff Surgery

Çelik¹,

Seçkin²,

Akman³

2017

Okmeydani Medical Journal

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ÖZ GİRİŞRotator manşet yırtıkları ve subakromial bölge sorunları omuz ağrısının yaygın nedenlerindendir. Rotator manşet yırtığı, 50-59 yaş aralığında %13 oranda gö-rülürken, bu oran 80 yaş üzerinde %51'e kadar yük-selmektedir (1) .Önceki yıllarda açık girişim ile yapılan rotator manşet onarımı yıllar içinde artroskopik tekniklerin geliş-mesi ile önce artroskopik yardımlı mini-açık tekniğe ardından yalnızca artroskopik tekniğe doğru kaymış-tır. Tedavide öncelikli hedef fonksiyonel bir rotator kablo yaratmak olan bu patolojide uygulanan tekniklerin birtakım komplikasyonları olduğu bilinmelidir. Rotator manşet cerrahisi sonrası kısa ve uzun dönem takip sırasında omuz ekleminde ağrı oluşması önem-senmeli, ağrı nedenleri cerrah tarafından sistematik olarak değerlendirilmelidir (Tablo 1).Rotator manşet cerrahisi komplikasyonları, ameliyat öncesi hastaya ve patolojiye ait sorunlara bağlı komplikasyonlar, ameliyat sırasındaki tekniğe ve cerraha ait sorunlar ile cerrahi sonrası özellikle fizik tedaviye ait sorunlar olarak kabaca üç gruba ayrılarak incelenebilir. Bu komplikasyonlar onarılan manşetin yeniden yırtılması, akromion kırıkları, yineleyen subakromial enflamasyon, heterotopik ossifikasyon, omuz sertliği, enfeksiyon, sinir yaralanmaları, deltoid kasın akromiona dikildiği yerden ayrılması ve omuzun öne çıkığı olarak ortaya çıkabilir (Tablo 2) (3) .Bu bölümde artroskopik omuz cerrahisine bağlı komplikasyonlar ve rotator manşet cerrahisine bağlı komplikasyonlar iki ayrı bölümde değerlendirilmiştir.

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Management of Chronic Deep Infection Following Rotator Cuff Repair*

Cited by 91 publications

References 14 publications

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

The Use of Regional Flaps for the Repair of Synovio-Cutaneous Fistulas of the Shoulder after Attempted Rotator Cuff Repair: A Report of Two Cases

Review: Complications of Rotator Cuff Surgery

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