Key aspects of soft tissue management in fracture-related infection : recommendations from an international expert group
© 2023. The Author(s)..
A judicious, well-planned bone and soft tissue debridement remains one of the cornerstones of state-of-the-art treatment of fracture-related infection (FRI). Meticulous surgical excision of all non-viable tissue can, however, lead to the creation of large soft tissue defects. The management of these defects is complex and numerous factors need to be considered when selecting the most appropriate approach. This narrative review summarizes the current evidence with respect to soft tissue management in patients diagnosed with FRI. Specifically we discuss the optimal timing for tissue closure following debridement in cases of FRI, the need for negative microbiological culture results from the surgical site as a prerequisite for definitive wound closure, the optimal type of flap in case of large soft tissue defects caused by FRI and the role of negative pressure wound therapy (NPWT) in FRI. Finally, recommendations are made with regard to soft tissue management in FRI that should be useful for clinicians in daily clinical practice.Level of evidence Level V.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:144 |
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| Enthalten in: |
Archives of orthopaedic and trauma surgery - 144(2024), 1 vom: 26. Jan., Seite 259-268 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Marais, Leonard C [VerfasserIn] |
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| Links: |
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| Themen: |
Fasciocutaneous flap |
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| Anmerkungen: |
Date Completed 09.01.2024 Date Revised 11.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00402-023-05073-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364138475 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a A judicious, well-planned bone and soft tissue debridement remains one of the cornerstones of state-of-the-art treatment of fracture-related infection (FRI). Meticulous surgical excision of all non-viable tissue can, however, lead to the creation of large soft tissue defects. The management of these defects is complex and numerous factors need to be considered when selecting the most appropriate approach. This narrative review summarizes the current evidence with respect to soft tissue management in patients diagnosed with FRI. Specifically we discuss the optimal timing for tissue closure following debridement in cases of FRI, the need for negative microbiological culture results from the surgical site as a prerequisite for definitive wound closure, the optimal type of flap in case of large soft tissue defects caused by FRI and the role of negative pressure wound therapy (NPWT) in FRI. Finally, recommendations are made with regard to soft tissue management in FRI that should be useful for clinicians in daily clinical practice.Level of evidence Level V | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Fasciocutaneous flap | |
| 650 | 4 | |a Fracture | |
| 650 | 4 | |a Fracture-related infection | |
| 650 | 4 | |a Infection | |
| 650 | 4 | |a Muscle flap | |
| 650 | 4 | |a Negative pressure wound therapy | |
| 650 | 4 | |a Soft tissue closure | |
| 650 | 4 | |a Soft tissue cover | |
| 650 | 4 | |a Soft tissue defects, flap | |
| 700 | 1 | |a Hungerer, Sven |e verfasserin |4 aut | |
| 700 | 1 | |a Eckardt, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Zalavras, Charalampos |e verfasserin |4 aut | |
| 700 | 1 | |a Obremskey, William T |e verfasserin |4 aut | |
| 700 | 1 | |a Ramsden, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a McNally, Martin A |e verfasserin |4 aut | |
| 700 | 1 | |a Morgenstern, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Metsemakers, Willem-Jan |e verfasserin |4 aut | |
| 700 | 0 | |a FRI Consensus Group |e verfasserin |4 aut | |
| 700 | 1 | |a Obremskey, William T |e investigator |4 oth | |
| 700 | 1 | |a McNally, Martin A |e investigator |4 oth | |
| 700 | 1 | |a Atkins, Bridget L |e investigator |4 oth | |
| 700 | 1 | |a Borens, Olivier |e investigator |4 oth | |
| 700 | 1 | |a Depypere, Melissa |e investigator |4 oth | |
| 700 | 1 | |a Egol, Kenneth A |e investigator |4 oth | |
| 700 | 1 | |a Fragomen, Austin T |e investigator |4 oth | |
| 700 | 1 | |a Onsea, Jolien |e investigator |4 oth | |
| 700 | 1 | |a Govaert, Geertje A M |e investigator |4 oth | |
| 700 | 1 | |a Kates, Stephen L |e investigator |4 oth | |
| 700 | 1 | |a Kuehl, Richard |e investigator |4 oth | |
| 700 | 1 | |a Mcfadyen, Ian |e investigator |4 oth | |
| 700 | 1 | |a Fintan Moriarty, T |e investigator |4 oth | |
| 700 | 1 | |a Raschke, Michael |e investigator |4 oth | |
| 700 | 1 | |a Richards, R Geoff |e investigator |4 oth | |
| 700 | 1 | |a Sancineto, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Senneville, Eric |e investigator |4 oth | |
| 700 | 1 | |a Trampuz, Andrej |e investigator |4 oth | |
| 700 | 1 | |a Verhofstad, Michael H J |e investigator |4 oth | |
| 700 | 1 | |a Zimmerli, Werner |e investigator |4 oth | |
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