The treatment of pyogenic bone and joint infections by closed irrigation-suction.

An improved method of closed irrigation-suction treatment of bone and joint infections is described. The method utilizes a crisscross flow-reversal system using a double tube which prevents obstruction of the tube. A series of 154 patients with acute and chronic bone and joint infections were treated with closed irrigation in 172 closed irrigation-suction procedures. One hundred forty-eight cases (86.0%) were treated successfully, 7 cases (4.1%) were improved, and 17 cases (9.9%) were failures. Blood concentration levels of antibiotics were examined during closed irrigation. Absorption of antibiotics from the wound was insignificant. Culture and sentivity tests of drainage during closed irrigation are used to monitor the cleansing of the wound. Serum hepatitis was seen in 4 cases within the hematogenous group and in 6 cases within the traumatic group. Postoperative bleeding during irrigation was an important complication.