Advances in the understanding and treatment of musculoskeletal infections.
Musculoskeletal infections are a challenging treatment problem for orthopaedic surgeons. Despite advances in aseptic techniques and improved chemotherapeutic options, there has not been a substantial decrease in the incidence of musculoskeletal infections for the past quarter century. Understanding how microbes gain a foothold in tissue and bone and establish a chronic infectious state is imperative to the successful treatment of bone and soft-tissue infections. The methodic establishment of microbes in a sessile state in a mature biofilm represents the basis for instituting a chronic microbial defense system and sustainability in a host. To properly eradicate such infections requires a stepwise treatment algorithm of meticulous and thorough débridement, dead-space management, and soft-tissue and bone reconstruction. A comprehensive understanding of the reconstruction ladder combined with a detailed treatment plan from the initial staging of an infection through final reconstruction can cure an infection and achieve good functional results for patients.
Clinical Professor and Chief, Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, California.
David W
DW
Lowenberg
J Tracy
JT
Watson
L Scott
LS
Levin
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001850:Bone Diseases, Infectious / Q000628:therapy*; D003646:Debridement / Q000379:methods*; D006801:Humans; D018461:Soft Tissue Infections / Q000628:therapy*
D000900:Anti-Bacterial Agents