AAOS Systematic Literature Review: Summary on the Management of Surgical Site Infections.

AAOS Systematic Literature Review: Summary on the Management of Surgical Site Infections. J Am Acad Orthop Surg. 2018 Dec 28;: Authors: McLaren AC, Lundy DW Abstract The purpose of this systematic review is to improve outcomes for the care of surgical site infections by presenting the current best evidence on important diagnostic and care issues. The findings led to ten recommendations and five consensus statements that address diagnosis and treatment of orthopaedic surgical site infections. There is strong evidence to supports anemia, obesity, HIV/AIDS, depression, dementia, immunosuppressive medications, duration of hospital stay, history of alcohol abuse, and history of congestive heart failure as factors that increased the risk of infection, some of which are modifiable before surgical intervention. Diagnostically, synovial fluid and tissue cultures were found to be strong "rule-in" tests for the diagnosis of infection, but negative synovial fluid and tissue cultures do not reliably exclude infection. C-reactive protein was found to be a strong rule-in and rule-out marker for patients with suspected surgical site infections. Therapeutically, only for patients with retained implants, antimicrobial protocols of 8 weeks of duration were found to be associated with outcomes that are not inferior to outcomes from protocols of 3- to 6-month duration. Also only for patients with retained implants, rifampin, used as a second antimicrobia...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research