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Orthopaedics
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
In adults bone infection is introduced either via open fractures or by surgical procedures. It may be eliminated by the usual surgical techniques of clearance of all the infective material and all the implants, and large doses of antibiotics. Sadly, in spite of such vigorous treatment, recurrence is likely.
Infection of the bones and joints
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The pattern of bone infection is changing. Worldwide, childhood acute haematogenous osteomyelitis and septic arthritis are common, with chronic disease following inadequate initial management. In resource-rich countries, bone infection is now mostly seen after injury or surgery (contiguous focus osteomyelitis) and is often implant-related (Figure38.1). The high number of patients with comorbidities (diabetes, peripheral vascular disease, immunocompromise), more frequent bone and joint surgery and longer population survival contribute to a group of patients with increased susceptibility to infection. In the UK, the number of prosthetic joint replacements (hip, knee) has doubled in 15 years. It is projected that, in the USA, there will be around 65 000 new infected joints in 2020. Although the incidence of infection after fracture has decreased, the increased use of internal fixation has increased the prevalence of post-traumatic bone infection overall. This will produce a significant economic burden for healthcare providers in the future.
Musculoskeletal cases
Published in Lt Col Edward Sellon, David C Howlett, Nick Taylor, Radiology for Medical Finals, 2017
The history and XR appearances are typical of osteomyelitis, in this case secondary to underlying diabetes mellitus.Osteomyelitis or bone infection can occur secondary to haematogenous or direct spread of infection. In diabetes it is often secondary to direct spread from a pressure ulcer.The most common causative organism is Staphylococcus aureus.Salmonella infection is associated with sickle cell anaemia patients.In the early stages of osteomyelitis the XR may be normal. Soft tissue swelling andobliteration of fat planes are early signs. Bone destruction is a late feature (Figure 8.4C).Management involves I V antibiotics, debridement of large abscesses, and surgery forprogressive disease.
Effectiveness of an Online Course on Fracture-Related Infections
Published in Journal of European CME, 2022
Matheus Lemos Azi, Kodi Edson Kojima, Rodrigo Pesántez, Guido Carabelli, Olivier Borens, Iain McFadyen, Carlos Oliver Valderrama-Molina
Postoperative bone infection is a severe complication that can arise during the treatment of fractures. Several scientific organisations have collaborated to generate a definition for fracture-related infection (FRI) that addresses the unique characteristics of this clinical entity[7]. Furthermore, in a series of publications, this consensus group reviewed best practices for the diagnosis and treatment of FRI [7,8]. Most of these guidelines were published in English over the last three years and much of this information has not yet been incorporated into classic textbooks. As such, many young surgeons and residents in non-English speaking countries remain unaware of these new concepts. Thus, an online “FRI course” appeared to us to be a perfect model to evaluate whether an online course format can be effective at updating course participants and introduce new competencies.
Calcium alginate nanoparticle crosslinked phosphorylated polyallylamine to the controlled release of clindamycin for osteomyelitis treatment
Published in Drug Development and Industrial Pharmacy, 2021
Murugesan Gowri, Nachimuthu Latha, Kannan Suganya, Marudhamuthu Murugan, Mariappan Rajan
The leading causes of bone infection are open fracture, bone trauma, rheumatoid arthritis, malnutrition, and implant surgery failure [1–3]. One of the bacterial bone infection disease is Osteomyelitis [4]. Pathogens of significant concern in Osteomyelitis include Staphylococcus aureus [5], Staphylococcus epidermis [6], Enterobacter cloacae [7], and Pseudomonas aeruginosa [8]. Once infection sets in bone tissue, it causes impaired blood supply at the infected sites and disturbs the bone structure and function [9]. To effectively treat infected or contaminated bone defects, it is essential to administer antibacterial agents loaded into the bone implants to manage the infection. An antimicrobial agent such as Clindamycin is the appropriate choice for Osteomyelitis treatment [10]. Clindamycin drug is a member of the Lincosamide group, and it is active against aerobic gram-positive aerobic and anaerobic gram-negative bacteria [11]. It is used to treat skin and soft tissue, respiratory tract, pelvic, intra-abdominal, and bone infections [12]. The continuous use of antibiotics carries some risks such as rising antibiotic resistance, poor bioavailability, and abuse, and causes side effects such as rash, abdominal pain, and other gastrointestinal effects [13–15]. The efficient systemic administration of antibiotics is partially successful because of insufficient local blood supply and bacterial biofilm formation that can hamper antibiotic efficacy [16].
Preparation, in vitro release and antibacterial activity evaluation of rifampicin and moxifloxacin-loaded poly(D,L-lactide-co-glycolide) microspheres
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
ZeWen Qiao, Zhi Yuan, Wenping Zhang, Daihao Wei, Ningmin Hu
Osteomyelitis is caused by open fractures and following orthopaedic reconstruction operations is a serious complication [1,2]. Bacteria can invade the body via an invasive surgery or trauma and adhere to the surface of the implant or ischaemic bone. Bacteria rapidly replicates and results in severe inflammation. Osteomyelitis is more difficult to treat as it easily relapses than other infectious diseases in the body and mainly attributed to three aspects. First, intravenous antibiotics cannot easily reach the infected bone owing to the blood–bone barrier [3]. Second, bacteria form a biofilm to protect them against the body’s defence mechanisms and against antibiotics, resulting in a continuous production of pathogens that worsens inflammation [4–6]. Third, osteomyelitis is usually caused by Staphylococcus aureus, which accounts for approximately 80% of all pathogenic bacteria and tends to form biofilms [7]. Reportedly, S. aureus that is engulfed by osteoblasts lives within them, which alters the function of osteoblasts, leading to bone destruction [8]. Thus, the organism evades immune responses, body fluids and antibacterial agents. Therefore, several problems must be solved to treat osteomyelitis, such as improving bactericidal concentration at the infected site, inhibiting bacterial biofilm formation, killing bacteria within the biofilm and determining the antibacterial agents that can be used in bone infection.