[Treatment of MRSA infection in orthopedic surgery].
BACKGROUND
Infection with methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge both therapeutically and hygienically.


METHODS
Between January 2000 and January 2002, 27 patients with MRSA infections were treated and evaluated in a prospective clinical study. For effective wound management, operative revisions were performed every 3rd day. Following debridement, the wounds were vacuum sealed and specific i.v. antibiotics were administered. Wound closure was performed if three consecutive wound samples submitted for bacterial culture remained negative.


RESULTS
All patients with MRSA infections were treated successfully until signs of infection disappeared and bacterial cultures were negative. An average of 7.3 operations per patient was required to eradicate MRSA infection. Follow-up of patients revealed recurrence of infection in four patients.


CONCLUSIONS
Prevention of further spreading and successful treatment of MRSA infections in reconstructive orthopedic surgery is possible with appropriate surgical and hygienic concepts. In almost every second patient complex revision procedures were required.
Mückley
Th
T
Berufsgenossenschaftliche Unfallklinik Murnau. T.Mueckley@gmx.de
Hierholzer
Ch
Ch
Diefenbeck
M
M
Hofmann
G O
GO
Bühren
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001134:Arm Injuries / Q000601:surgery*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003428:Cross Infection / Q000601:surgery*; D003646:Debridement; D018432:Drug Resistance, Multiple; D005260:Female; D005858:Germany; D006801:Humans; D007262:Infusions, Intravenous; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009779:Occlusive Dressings; D012086:Reoperation; D012307:Risk Factors; D055502:Secondary Prevention; D013203:Staphylococcal Infections / Q000601:surgery*; D013530:Surgical Wound Infection / Q000601:surgery*
D000900:Anti-Bacterial Agents