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Treatment Algorithm for Surgical Site Infections Following Extensor Mechanism Repair
Eric R Taleghani1, Stephen R Thompson2, Seth R Yarboro1
1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
JBJS Reviews
|January 6, 2021
Summary
Managing surgical site infections (SSIs) after extensor mechanism repair requires prompt action. Superficial SSIs can be treated outpatient, while deep SSIs necessitate aggressive surgical intervention and antibiotics.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Extensor mechanism repair is common, but post-operative surgical site infections (SSIs) lack clear management guidelines.
- Limited literature exists on effectively treating SSIs following these procedures.
Purpose of the Study:
- To provide guidance on managing surgical site infections (SSIs) after extensor mechanism repair.
- To outline strategies for both superficial and deep SSIs.
Main Methods:
- Review of current literature and clinical experience for SSI management.
- Differentiating treatment based on SSI depth and presentation.
- Emphasis on early diagnosis and intervention, including arthrocentesis and surgical debridement.
Main Results:
- Superficial SSIs (e.g., cellulitis) may be managed outpatient with close monitoring.
- Deep SSIs require aggressive surgical irrigation and debridement (I&D), suture management, and targeted antibiotics.
- Early arthrocentesis is crucial for diagnosing septic joints, necessitating prompt I&D.
Conclusions:
- A tiered approach is essential for managing SSIs after extensor mechanism repair.
- Prompt and aggressive management of deep SSIs, including joint involvement, improves outcomes.
- Refractory cases may require plastic surgery consultation and vigilance for osteomyelitis.
