PMID: 6536381Apr 1, 1984Paper

The infected implant

Clinics in Podiatry
L A Sorto

Abstract

In summary, I believe that when faced with a definitely diagnosed deep infection involving a joint replacement of the foot, the treatment of choice is incision and drainage of the wound with removal of the implant and all necrotic bone and soft tissue. Postoperatively, some form of drainage-promoting system should be instituted. Three techniques for promoting drainage have been discussed: open packing, which technically is the easiest to accomplish, but necessitates either delayed primary closure, healing by secondary intention, or in some cases skin grafting; this obviously increases disability time; standard closed suction irrigation, which has the advantage of primary wound closure but the disadvantage of requiring around-the-clock supervision to ensure against blockage of fluid flow, especially through the egress tube; and the Sorto modification of the one-tube in-out drainage system, which has the same advantage as closed suction irrigation (primary wound closure) without the risk of blockage of the egress tube. The key to successful management of an infected implant is immediate and aggressive treatment once a definitive diagnosis is made. Although the systemic use of antibiotics is an important adjunct in the total treat...Continue Reading

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