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Infection01:20

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When a pathogen enters the body and reproduces, it can cause an infection, damage body cells, and cause illness symptoms that eventually lead to disease. Therefore, its prevention requires breaking the chain of infection.
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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Cleaning, Sterilization, and Disinfection01:30

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Pathogen-Specific Risk for Iterative Surgical Debridement in Orthopedic Infections: A Prospective Multicohort

Flamur Zendeli1, Anna Jędrusik2, Raymond O Schaefer1

  • 1Department of Orthopedic Surgery, Balgrist University Hospital, 8008 Zurich, Switzerland.

Journal of Clinical Medicine
|December 30, 2025
PubMed
Summary
This summary is machine-generated.

Gram-negative bacteria and infected orthopedic implants significantly increase the need for repeat surgeries, known as "second looks," to control infections. This finding aids in planning patient care and antibiotic strategies for better outcomes.

Keywords:
multiple proceduresorthopedic infectionsurgical debridement

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Orthopedic infections often necessitate repeated surgical debridement and antimicrobial therapy.
  • The frequency of debridement procedures, including "second looks," varies widely.
  • Identifying pathogens associated with multiple debridements is crucial for infection control.

Purpose of the Study:

  • To investigate the association between specific bacterial pathogens and the requirement for multiple debridement procedures ("second looks") in orthopedic infections.
  • To identify risk factors for repeat surgical interventions in managing orthopedic infections.

Main Methods:

  • Analysis of a composite database from three prospective randomized controlled trials (RCTs) conducted between 2019 and 2025.
  • Protocoled initial surgical debridement with additional debridement permitted only for persistent or progressive local infection.
  • Multivariable logistic regression was used to identify independent associations.

Main Results:

  • 18.8% of orthopedic infections (201/1067) required multiple debridement procedures, with a median of two additional interventions.
  • Gram-negative pathogens (28.2%) and implant-related infections (25.4%) showed the highest risk for "second looks."
  • Gram-negative infections (OR 2.04) and infected implants (OR 2.18) were independently associated with multiple interventions, unlike Staphylococcus aureus, Enterococci, or Streptococci.

Conclusions:

  • Gram-negative pathogens are significantly linked to the need for repeat debridement in orthopedic infections.
  • Infected implants also represent a significant risk factor for requiring multiple surgical interventions.
  • Findings inform preoperative counseling, antibiotic stewardship, and surgical planning for staged management in high-risk cases.