Diagnosis and management of chronic infection
| Autor: | George Cierny, Benjamin K. Potter, Lawrence X. Webb, Jonathan A. Forsberg |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Diagnostic Imaging
medicine.medical_specialty medicine.medical_treatment Scintigraphy Severity of Illness Index Severity of illness medicine Humans Orthopedics and Sports Medicine Dosing Intensive care medicine High prevalence Debridement medicine.diagnostic_test business.industry Prognosis Response to treatment Surgery Anti-Bacterial Agents Chronic infection Chronic osteomyelitis Chronic Disease Wound Infection business |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons. 19 |
| ISSN: | 1067-151X |
| Popis: | High-energy penetrating extremity injuries are often associated with severe open fractures that have varying degrees of soft-tissue contamination and tenuous soft-tissue coverage. The result is a relatively high prevalence of chronic osteomyelitis compared with that in civilian trauma patients. Diagnosing chronic osteomyelitis requires a careful history and thorough physical and radiographic examinations. Cross-sectional imaging can help delineate the extent of bony involvement, and scintigraphy can be used as a diagnostic tool and to gauge response to treatment. Clinical staging also directs surgical management. Adequacy of debridement remains the most important clinical predictor of success; thus, adopting an oncologic approach to complete (ie, wide) excision is important. Reconstruction can be safely performed by a variety of methods; however, proper staging and patient selection remain critical to a successful outcome. Although systemic and depot delivery of antibiotics plays a supporting role in the treatment of chronic osteomyelitis, the ideal dosing regimens, and the duration of treatment, remain controversial. |
| Databáze: | OpenAIRE |
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