[Post-traumatic osteitis. The acute infection].

Abstract

The acute infection is defined as bacterial growth within the surgical wound, that may occur within days to weeks after initial surgery but before bone union. The chances of complete recovery after an acute soft tissue inflammation are closely related to the interval between initial surgery and first signs of infection, the early recognition of the complication, the type of bacteria involved and the therapeutic measures. The first symptoms of an impending infection are the classical clinical ones of any inflammation: tenderness, swelling and reddening. All imaging procedures are of little or no value. The therapy consists of very aggressive and, if required, repeated wound revisions with debridement of all necrotic tissue, removal of loose bone fragments or loose implant material, wash-outs with antiseptic solutions (e.g. Taurolin) or even deposition of gentamycin beads. Systemic antibiotics may be added temporarily. The in- or external fixation devices must provide stable fracture fixation and the bone as well as the soft tissue envelope must be well vascularized.