Sandro Hodel1, Tobias Koller2, Björn-Christian Link3, Marco Rossi4, Reto Babst5, Frank J P Beeres6. 1. Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: sandro.hodel@balgrist.ch. 2. Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: tobias.koller@luks.ch. 3. Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: bjoern-christian.link@luks.ch. 4. Department of Infectiology, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: marco.rossi@luks.ch. 5. Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: reto.babst@luks.ch. 6. Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland. Electronic address: frank.beeres@luks.ch.
Abstract
INTRODUCTION: Temporary external fixation is a viable option for numerous conditions and fixations in orthopaedic and trauma surgery. If the external fixator is left in place it is necessary to disinfect it prior to surgery, yet the subsequent risk for bacterial contamination of the surgical site originating from the external fixator remains unknown. MATERIAL AND METHODS: In a prospective study, samples were taken at the time of definitive osteosynthesis to assess bacterial contamination of the surgical site and the external fixator in twenty consecutive patients treated with temporary external fixation for closed fractures from October 2016 until March 2017. RESULTS: Twenty external fixators of twenty patients with complete sampling and a mean follow-up of seven months (range: 3-14) were available for analysis. Ten out of 120 cultures of the surgical site (8.3%) were positive for bacterial growth in a total of seven patients (35%). Pathogen's detected were Propionibacterium acnes (60%) and Staphylococcus epidermidis (30%). No contamination of the external fixator was detected. CONCLUSION: We conclude that the presented perioperative management to decontaminate external fixators allows for a safe definitive osteosynthesis in a staged protocol without increasing bacterial contamination of the surgical site. It is safe to leave the external fixator in place for definitive osteosynthesis.
INTRODUCTION: Temporary external fixation is a viable option for numerous conditions and fixations in orthopaedic and trauma surgery. If the external fixator is left in place it is necessary to disinfect it prior to surgery, yet the subsequent risk for bacterial contamination of the surgical site originating from the external fixator remains unknown. MATERIAL AND METHODS: In a prospective study, samples were taken at the time of definitive osteosynthesis to assess bacterial contamination of the surgical site and the external fixator in twenty consecutive patients treated with temporary external fixation for closed fractures from October 2016 until March 2017. RESULTS: Twenty external fixators of twenty patients with complete sampling and a mean follow-up of seven months (range: 3-14) were available for analysis. Ten out of 120 cultures of the surgical site (8.3%) were positive for bacterial growth in a total of seven patients (35%). Pathogen's detected were Propionibacterium acnes (60%) and Staphylococcus epidermidis (30%). No contamination of the external fixator was detected. CONCLUSION: We conclude that the presented perioperative management to decontaminate external fixators allows for a safe definitive osteosynthesis in a staged protocol without increasing bacterial contamination of the surgical site. It is safe to leave the external fixator in place for definitive osteosynthesis.
Authors: Julio Cesar DO Amaral Mussatto; Fernando Balsimelli; Guilherme DO Amaral Mussatto; Caio Zamboni; Ralph Walter Christian; Marcelo Tomanik Mercadante Journal: Acta Ortop Bras Date: 2022-08-26 Impact factor: 0.683