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prevention of infection in orthopaedics

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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

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