Mohd Yusof, Nazri
(2023)
Fracture related infection : approach to diagnosis.
In: 52 Nd Malaysian Orthopaedic Association Annual Scientific Meeting / Annual General Meeting 2023, 15th to 17th June 2023, Setia Spice Convention Centre, Penang.
(Unpublished)
Abstract
Fracure-related infection is a condition which includes surgical site infection, implant-related infection, post-traumatic osteomyelitis, infected fractures or infected nonunion. A standardised diagnostic criteria and an algorithm were introduced from a consensus of a group of experts to get a clear definition. A confirmatory criteria includes clinical features of sinus or wound breakdown exposing the bone and implant or the presence of pus during surgery. confirmatory investigations results include pathogens identified from at least 2 deep intraoperative deep cultures or the presence of microorganisms in the histopathological examination. Suggestive criteria are not specific clinical symptoms such as fever, swelling, warmth or pain. It also includes investigations such as bone lysis, periosteal reaction or implant loosening on plain radiograph, high inflammatory markers, single positive cultures, persistent wound drainage or joint effusion. In the presence of suggestive features or even confirmatory clinical features, intraoperative microbiological specimens should be done to confirm the diagnosis and identify the organism and its antibiotic sensitivity. This approach is almost similar to the oncology approach to get a tissue diagnosis before deciding on the patient's management.
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