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Successful treatment of infected wound dehiscence after minimally invasive locking-plate osteosynthesis of tibial pilon and calcaneal fractures by plate preservation, surgical debridement and antibiotics
- Source :
- The Foot. 33:44-47
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Objective The aim is to present a case series that illustrates possible benefits from combining minimally invasive plate osteosynthesis (MIPO), plastic surgery and antibiotic therapy, in order to treat and eradicate infection in patients with tibial pilon or calcaneal fractures. Methods Eleven consecutive patients with dehiscence of the surgical wound in outcomes MIPO using a Locking Compression Plate (LCP) for tibial pilon, or calcaneus fractures. The patients had developed a documented infection of the surgical wound. All patients were treated and followed-up by the multidisciplinary team with the orthopedic surgeon, the plastic surgeon and the infectious disease physician. All patients were followed by the plastic surgeon to treat the wound dehiscence, as well as by the orthopedic surgeon until fracture consolidation. The duration of the antibiotic therapy was from 4 to 6 months. After 6 weeks, the intravenous treatment was replaced by oral administration. The follow-up intervals were 15 days, 40 days, and 3 months. Results The average time of wound closure was 109 ± 60 days. The antibiotics used were chosen according to the antibiogram. The antibiotic therapy had a duration of 4–6 months, and after 6 weeks, the therapy switched to oral administration. At the 3-month follow-up, all patients had excellent outcomes and had returned to their normal activity of daily living. Conclusion The patients in this study responded positively to a combination of MIPO, plastic surgery and antibiotic therapy, confirming that multidisplinary treatment in association with titanium devices are able to eradicate infection in short time.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.drug_class
Antibiotics
Dehiscence
Ankle Fractures
Risk Assessment
Cohort Studies
Fracture Fixation, Internal
Fractures, Bone
03 medical and health sciences
0302 clinical medicine
Surgical Wound Dehiscence
Humans
Minimally Invasive Surgical Procedures
Surgical Wound Infection
Medicine
Orthopedics and Sports Medicine
030212 general & internal medicine
Surgery, Plastic
Podiatry
Infusions, Intravenous
Retrospective Studies
Wound Healing
030222 orthopedics
Osteosynthesis
business.industry
Wound dehiscence
Surgical wound
Middle Aged
medicine.disease
Combined Modality Therapy
Anti-Bacterial Agents
Surgery
Tibial Fractures
Calcaneus
Plastic surgery
Treatment Outcome
Debridement
Orthopedic surgery
Female
business
Bone Plates
Follow-Up Studies
Subjects
Details
- ISSN :
- 09582592
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- The Foot
- Accession number :
- edsair.doi.dedup.....d5cccdbef23751dbf74823b9860f7e3c