Prevention of infection in orthopaedics

Infection during orthopaedic surgery is a major problem:

• in the acute phase it perpetuates pain and deformity
• chronic infection has other complications.

The main factors in preventing infection are:

• a good state of pre-operative health
• good aseptic technique in theatre
• a clean air environment
• careful handling of tissues during the operation

Prophylactic antibiotics should be considered in patients undergoing:

• joint replacement therapy
• internal fixation of closed fractures
• specific elective procedures, e.g. spinal surgery

Open fractures are invariably contaminated and should be treated with:

• debridement
• possible delayed primary closure
• antibiotics.