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The management of orthopedic infection is an area of growing importance in orthopedic surgery. This text provides a complete overview from basic research to clinical application and future perspectives in the treatment of orthopedic infection emphasizing the role of local therapy. Coverage details the various approaches to the treatment of orthopedic infections, making the book an important tool for the daily practice of its readers.
This comprehensive, clinically oriented reference details the state-of-the-art approach to infections of bones and joints. Utility for all practitioners is ensured by the wide range of contributors who include infectious disease specialists, rheumatologists, orthopedic surgeons, and radiologists. This is the definitive resource for the clinician who treats orthopedic infections.
This book outlines the most updated clinical guidelines that are vital for the prevention infections and care of patients with joint infections following a replacement surgery, one of the highest volume medical interventions globally. Sections address the diagnosis, management approaches and prevention of prosthetic joint infections. Written by experts in the field, this text provides a brief overview of the literature and current recommendations in each of the specified areas. Given the rapidly evolving state-of-play in this clinical area, this compendium grows increasingly important to clinicians in their management decisions. Prosthetic Joint Infections is a valuable resource for infectious disease specialists, epidemiologists, surgeons, and orthopedic specialists who may work with patients with prosthetic joint infections.
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.
Infections of the bones (osteomyelitis) and joints (septic arthritis) are serious health problems which require antibiotics and often surgery. Awareness among health professionals of the causes and treatment options for various types of bone and joint infections is essential for effective resolution. Bone and Joint Infections takes a multidisciplinary approach in covering the diagnostic and therapeutic treatment of osteomyelitis and septic arthritis, including different types of implant-associated infections. Correct and rapid diagnosis of bone and joint infection is crucial, and requires the input of a variety of specialists. Bone and Joint Infection takes a similarly collaborative and comprehensive approach, including chapters authored by clinicians, laboratory specialists, and surgeons. Covering the basic microbiology and clinical aspects of bone and joint infection, this book will be a valuable resource both for researchers in the lab and for physicians and surgeons seeking a comprehensive reference on osteomyelitis and septic arthritis.
Bone and soft tissue sarcomas represent only about 2% of all malignancies; however, their treatment – with the goal of curing the patient while preserving the functionality of the affected body part – can, unlike other malignancies, only be successful with therapy concepts devised by interdisciplinary teams. This volume provides an extensive up-to-date overview of the specific diagnostics and current treatment standards of these rare entities, presenting the various limb-sparing modalities for patients with bone and soft tissue sarcomas with special regard to innovative reconstructive options. The evaluation of quality of life based on validated scores and the individual methods of coping with the illness through creative artistic projects are also acknowledged and integrated in the whole concept.
This book Periprosthetic Joint Infection is a portable guide to the practical management of surgical site infections following orthopedic procedures. It designed to help answer clinician's questions regarding the prevention and treatment of periprosthetic infections. It organized for rapid review, featuring evidence reviews, pitfalls, Rothman Institute Current Practices and Controversies. The guide is being included in the course materials for the 29th Annual Current Concepts in Joint Replacement® (CCJR) meeting thanks to a generous educational grant from 3M Health Care.
Management of Periprosthetic Joint Infections (PJIs): Management of PJIs discusses periprosthetic joint infection (PJI), a fairly rare occurrence that is nonetheless one of the most serious complications in joint replacement surgery. Intricate interactions between the pathogen, the host, and the implant can result in PJIs which are not only physically devastating for the patient, but also financially crippling for health authorities and insurance companies. Actions taken to minimize the risk of PJIs can be extremely challenging for the orthopaedic community. Consequently, new research, which is detailed in this comprehensive book, is being undertaken to minimize and manage these challenging infections. - Provides essential background knowledge on the mechanisms and identification of PJIs - Dedicated chapters focus on the complex, but vital eccentricities between PJIs in different areas of the body - Contains contributions from a mixture of clinical and academic experts in the field, thus ensuring balanced coverage
Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
During the recent transition between acute diseases caused by swarms of single planktonic bacteria, and chronic infections caused by bacteria growing in slime-enclosed biofilms, a general clinical consensus has emerged that pathologies with bacterial etiologies are frequently culture negative. Because biofilm infections now affect 17 million Americans per year (killing approximately 450,000), the suggestion that these common and lethal infections regularly go unnoticed by the only FDA-approved method for their detection and characterization is a matter of urgent concern. Biologically, we would expect that planktonic bacterial cells would colonize any new surface, including the surface of an agar plate, while the specialized sessile cells of a biofilm community would have no such proclivity. In the study of biofilm diseases ranging from otitis media to prostatitis, it was found that direct microscopy and DNA- and RNA-based molecular methods regularly document the presence of living bacteria in tissues and samples that are culture negative. The editors selected orthopedic biofilm infections as the subject of this book because these infections occur against a background of microbiological sterility in which modern molecular methods would be expected to find bacterial DNA, RNA-based microscopic methods would be expected to locate bacterial cells, and cultures would be negative. Moreover, in Orthopedics we find an already biofilm-adapted surgical group in which current strategies are based on the meticulous removal of compromised tissues, antibiotic options as based on high biofilm-killing local doses, and there are practical bedside strategies for dealing with biofilm infections. So here is where the new paradigm of biofilm infection meets the equally new paradigm of the culture negativity of biofilms, and this volume presents a conceptual synthesis that may soon combine the most effective molecular methods for the detection and identification of bacteria with a surgical discipline that is ready to help patients.