Prepatellar Septic Bursitis: A Case Report of Skin Necrosis Associated With Open Bursectomy

Gendernalik, James D.; Sechriest, V. Franklin

doi:10.7205/milmed-d-03-7608

Cited by 11 publications

(8 citation statements)

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“…Gendernalik et al [3] reported a case of skin necrosis associated with open bursectomy and the application of a continuous vacuum dressing. Failure to appreciate the tenuous blood supply to the overlying skin can result wound dehiscence and sinus formation.…”

Section: Discussionmentioning

confidence: 98%

“…Prompt treatment with the appropriate antibiotics often avoids the need for surgical debridement. There are a number of potential complications in performing open debridement in this setting such as wound breakdown and skin necrosis, which is not only a significant morbidity for the patient but also requires a prolonged hospital admission with multiple surgeries [3]. The successful non-operative management with intravenous antibiotics alone has been reported but the average hospital admission for this cohort of patients was 11 days [4].…”

Section: Introductionmentioning

confidence: 98%

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Endoscopic bursectomy for the treatment of septic pre-patellar bursitis: a case series

Dillon

Freedman

Tan

et al. 2012

Arch Orthop Trauma Surg

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Endoscopic bursectomy for the treatment of septic pre-patellar bursitis: a case series

Dillon

Freedman

Tan

et al. 2012

Arch Orthop Trauma Surg

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“…Prepatellar septic bursitis is usually successfully managed non-operatively with rest, compression, immobilisation, aspiration and antibiotics. Surgical bursectomy may rarely be required for recalcitrant cases [6] .…”

Section: Septic Bursitismentioning

confidence: 99%

Prepatellar Bursitis

2009

N Engl J Med

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A bursa is a small sac of fibrous tissue with a thin synovial lining that is filled with fluid. Numerous bursae are found in the body, around joints and in places where ligaments and tendons pass over bones. They can also form in other places as a response to unusual pressure or friction. Generally, bursae help to reduce friction and allow maximal range of motion around joints. Bursitis is inflammation within a bursa. The inflammation leads to an increase in synovial fluid production and causes the bursa to swell. There are four bursae located around the knee joint. They are all susceptible to bursitis but the prepatellar bursa is most commonly affected. Less frequently, the infrapatellar and deep patellar bursae can become inflamed [1]. The prepatellar bursa is located superficially on the anterior aspect of the knee between the skin and the patella. The bursa does not communicate with the knee joint and the knee joint itself is normal in prepatellar bursitis. Aetiology Prepatellar bursitis may occur due to: Acute trauma: fall/direct blow on to the knee. Recurrent minor injury: occurs after long periods of time spent kneeling forwards and putting pressure on the patella. Historically, this was typical of housemaids who spent long periods of time on their knees scrubbing floors; hence, the term 'housemaid's knee'. It is now more commonly seen in tradesmen-eg, carpet fitters, concrete finishers, roofers. Infection: pyogenic prepatellar bursitis is common in children. It may be mistaken for septic arthritis of the knee. Staphylococcus aureus is the usual causal agent. There is usually a history of a break in the skin prior to its onset. A co-existing inflammatory disease: for example, synovitis related to rheumatoid arthritis. A crystal-depositing condition: prepatellar bursitis is more common in people with gout or pseudogout.

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“…Recurrence rates have been reported as high as 20%. Complications of the open approach include wound haematoma, scar tenderness, damage to the infrapatellar branch of the saphenous nerve, seroma formation, and skin necrosis [5][6][7]. Endoscopic procedures are performed through multiple portals and can be effective in terms of postoperative recovery and cosmesis.…”

Section: Introductionmentioning

confidence: 99%