title: [Treatment concept for a traumatic lesion of the prepatellar bursa].
abstract: OBJECTIVE
  Rapid recovery of the skin and soft tissue of the affected knee joint with surgical debridement of the wound and gentle, as well as risk-balanced partial resection of the traumatic lacerated prepatellar bursa. Functional aftercare with directed administration of antibiotics only.
  
  
  METHODS
  Acute, traumatic laceration of the prepatellar bursa.
  
  
  METHODS
  Heavy contamination of the wound. Large, not closable skin defect or deep abrasion. Preexisting local infection. Additional fracture of the patella. Limited patient's cooperation, e. g., alcohol addiction or dementia.
  
  
  METHODS
  Subdermal application of local anesthesia through the exposed wound margins. Exploration of the wound and excision of the wound margins. Dissection of the boundary layer between the bursa and the subcutaneous fat. Debridement of the wound and excision of the bruised and contaminated bursa tissue. Repetitive rinsing. Insertion of loop drainage. Single-layer wound closure. Crepe bandage.
  
  
  METHODS
  Crepe bandage until the first wound inspection. Wound inspection on postoperative day 2 with removal of the loop. Pain-adapted functional treatment. Antithrombotic therapy until full weight-bearing. Removal of the stitches on postoperative day 14. Antibiotic prophylaxis (1st generation cephalosporin) for immunocompromised or polymorbid patients or heavily contaminated wounds.
  
  
  RESULTS
  In 2013, we treated 50 traumatic lacerations of the prepatellar bursa. Four had to undergo further surgical treatment after primary care. In two other patients, one infected and one non-infected wound healing complication developed, which could be treated conservatively.
authors: Universitätsklinik für Unfallchirurgie, Anichstr. 35, 6020, Innsbruck, Österreich. peter.kaiser@uki.at.
authors: P
authors: P
authors: Kaiser
authors: Universitätsklinik für Unfallchirurgie, Anichstr. 35, 6020, Innsbruck, Österreich.
authors: G
authors: G
authors: Schmidle
authors: Universitätsklinik für Unfallchirurgie, Anichstr. 35, 6020, Innsbruck, Österreich.
authors: C
authors: C
authors: Raas
authors: Universitätsklinik für Unfallchirurgie, Anichstr. 35, 6020, Innsbruck, Österreich.
authors: M
authors: M
authors: Blauth
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods; D002061:Bursa, Synovial / Q000601:surgery*; D002062:Bursitis / Q000601:surgery*; D002648:Child; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D004322:Drainage / Q000379:methods; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D022125:Lacerations / Q000601:surgery*; D010329:Patella / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bursectomy; Bursitis; Laceration; Prepatellar bursa; Wound healing