Sonication of intramedullary nails: Clinically-related infection and contamination
Entity
UAM. Departamento de CirugíaPublisher
Bentham OpenDate
2012Citation
Open Orthopaedics Journal 6 (2012): 255-260ISSN
1874-3250Funded by
Part of this work was funded by grants from the Comunidad de Madrid (S2009/MAT-1472) and from the CONSOLIDER-INGENIO Program (FUNCOAT-CSD2008- 00023). DMM was funded by a grant from the Fundación Conchita Rábago de Jiménez DíazProject
Comunidad de Madrid. S2009/MAT-1472/BITI; Gobierno de España. CONSOLIDER-INGENIO FUNCOAT-CSD2008- 00023Subjects
Intramedullary nail; Orthopaedic infection; Sonication; Infection diagnosis; Nail removal; Implant-related infection; MedicinaRights
© Esteban et al.Abstract
Background and Aim: Sonication is currently considered the best procedure for microbiological diagnosis of
implant-related osteoarticular infection, but studies in nail-related infections are lacking. The study aim was to evaluate
implant sonication after intramedullary nail explantation, and relate it to microbiological cultures and clinical outcome.
Patients and Methods: A study was performed in two University Hospitals from the same city. Thirty-one patients with
implanted nails were prospectively included, whether with clinical infection (8 cases) or without (23 cases). Retrieved
nails underwent sonication according a previously published protocol. The clinical and microbiological outcome patient
was related to the presence of microorganisms in the retrieved implant.
Results: Positive results appeared in 15/31 patients (9 with polymicrobial infections) almost doubling those clinically
infected cases. The most commonly isolated organisms were Staphylococcus epidermidis (19.2 %) and Staphylococcus
aureus (15.4 %). A significant relationship was found between the presence of positive cultures and previous local
superficial infection (p=0.019). The presence of usual pathogens was significantly related to clinical infection (p=0.005)
or local superficial infection (p=0.032). All patients with positive cultures showed pain diminution or absence of pain after
nail removal (15/15), but this only occurred in 8 (out of 16) patients with negative cultures.
Conclusions: In patients with previously diagnosed infection or local superficial infection, study of the hardware is
mandatory. In cases where pain or patient discomfort is observed, nail sonication can help diagnose the implant
colonization with potential pathogens that might require specific treatment to improve the final outcome
Files in this item
Google Scholar:Esteban Moreno, Jaime
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Sandoval, E.
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Cordero Ampuero, José
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Molina-Manso, D.
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Ortiz-Pérez, A.
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Fernández Roblas, Ricardo
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Gómez-Barrena, E.
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