[Infections following orthopedic surgical intervention]

Postoperative wound infection after implant and removal of osteosynthetic material

Osteosynthetic material was implanted and removal in 972 consecutive operations in the upper and lower extremity. Early post-operative wound infection developed significantly more often after osteosynthesis than after removal of the implant; neither sex nor age influenced significantly the frequency of wound infection. The latter was higher when insertion or removal of material was performed in the lower extremity than in the upper extremity. The hip and ankle regions were involved most often. Staph. aureus and Staph. albus predominated among the Gram-positive infections; gram-negative infections, however, occurred remarkably frequently, E. coli being the most common organism isolated. To decimate exogenous and endogenous contamination of the wounds during operation, aseptic and antiseptic measures should be reinforced. In operation in a region proven to carry a higher post-operative infectious risk, i.e. the hip and ankle, it is suggested that antibiotics should be administered at the time of osteosynthesis.