Evaluation Of Open Reduction And Internal Fixation Of Maxillofacial Fractures

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

In recent years, surgical site infections are verified as one of the most errors that are common in the healthcare; however, they are also preventable. These research papers will synthesis information about surgical infections, patient experience, hospital-acquired conditions and achievement of expected treatment for specific clinical diagnoses. A surgical site infection is an infected condition in the body after surgery has occurred. Surgical site infections are caused by germs, called bacteria. Different types of bacteria from the environment may cause a delay in healing. The infection may come from surgical tools or bacteria on the skin if it is not clean correctly. Healthcare professionals use certain guidelines and

1. Write a client outcome to help Mrs. Ross resolve the symptoms (i.e., defining characteristics). Refer to Section III (beginning on p. 119) of the Ackley and Ladwig text.

Catheter-Associated Urinary Tract Infection (UTI) 8.Vascular Catheter-Associated Infection 9. Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures 10. Certain Surgical Site Infections, including Mediastinitis after Coronary Artery Bypass Graft (CABG), following certain orthopedic procedures, and following bariatric surgery for obesity.

the two pathways and it requires that all factors are present within the blood for clotting

Aims: To evaluate in patients with a hip fracture the association between serum P1NP concentration (on admission) and clinical characteristics as well as short-term outcomes.

Hypovolemia can be due to many predisposing factors such as fracture and surgery. The patient experienced a type of open fracture which is categorize by a wound in combination with the fracture (Whiteing, N., 2008, p. 50). Open Reduction Internal Fixation (ORIF) is the most common surgical technique for patients with open fracture which also includes tibia and fibula (William, L & Hopper, P., 2011, p. 1071). Since it was a major surgery massive blood loss or hypovolemia can be experience by a patient who will undergo this procedure. Craft, J., Gordon C., & Tiziani, A. (2011, p. 895) states that hypovolemia is a decrease in extracellular fluid volume and decrease in blood volume. In addition, Buttaro, T., (2013, p. 982) implies that there is approximately two (2)

The current state of the art test to diagnose PJI include: synovial fluid analysis with 3-5 culture, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Interleukin-6 (IL-6) (surprisingly is not potentially available), and FDG-PET scan. However, the cost and availability of some of these test makes lead to (ESR) and (CRP) being the most common one. In addition, normally any implant leads to high levels of CRP and ESR during the first month after the surgery; consequently, distinguishing between normal high results due to the surgery vs. due to infection is difficult. Furthermore, analysis of the organism present in synovial fluid samples is challenged by contamination of the cultures, the different times needed (some samples show presence of bacteria/fungus as early as 3 days other take up to 10 days), small number of cultures leads to low accuracy. Once the infection is diagnosed, extraction of the implant and antimicrobial + antibiotic treatment is required. This brings to another issue, lack of patient compliance to attend follow up appointments and proceed with the

While open reduction and internal fixation (ORIF) methods permits direct visualization of the injured pelvis, there are highly variable wound complication rates ranging from 3.9% to 27% [4]. Critics of ORIF are concerned about the extremely high risk of infection post-operatively, which can increase from 18% to 27% for fractures treated early and late, respectively [5]. It is reasonable to consider a more minimally invasive technique such as percutaneous fixation, which uses screws to mechanically stabilize an unstable sacrum [6]. Percutaneous fixation with iliosacral screws, for example, have led to decreases in surgical time, exposure related hazards, and soft-tissue disruption [7].

Osteomyelitis is a broad and debilitating disease typically triggered by a variety of conditions. Osteomyelitis starts off as inflammation seen within bone and bone marrow that can quickly progress into a large, subclassified infection. The length of time the infection has been present in the body and whether or not there is a pus formation or increased density among the infected bone is commonly used to classify severity. Pyrogenic bacteria or mycobacteria systematically attack the route and anatomic location of the infection evolving acute conditions into chronic ones. “Staphylococcus Aureus is a gram-positive, round shaped, non-mobile cocci typically found in clusters inside these wounds. Staphylococcus Aureus is one of the most common causes of infections after injury or surgery and affects nearly 500,000 patients in hospitals each year. Staphylococcus Aureus belongs to the family Staphylcoccaceae and survives by affecting all known mammalian species including humans” (www.news-medical.net). Osteomyelitis can start in one area of the body while spreading through the blood stream into other bone regions. Typical treatment options for Osteomyelitis includes antibiotics, removal of

Surgery that involves an incision in the skin can lead to a wound infection afterwards. Most surgical wound infections are seen within 30 days after surgery. There may be pus draining from the wound site, can be red, painful or hot to the touch. It may present with a fever and

Orthopedic implants can be used for internal fixation of bone fractures and prosthetic joint replacement. When internal fixation is used for bone fractures the need for fixation is sometimes only temporarily and can be removed after consolidation of the fracture.1 Infection is an important complication after internal fixation with significant morbidity and even mortality. This is often caused by biofilm-producing bacteria.2 The risk of infection after internal fixation is between 0.4% and 16.1% depending on the fracture type. Infection rates are 1.8% for Gustilo type I fracture, an open fracture with a clean wound (wound <1 cm in length) and 16.1% for Gustilo type III C fracture, a fracture associated with an arterial injury requiring repair, irrespective of degree of

Measure of this concept is based on the stages of wound healing and the Centers of Disease Control

Wound healing takes place in stages. The earliest stage is the vascular response to a wound (Government, 2009). Next is the lag phase in which inflammation has set in. It is during this time period that the wound is most vulnerable to complications (Mulholland and Doherty, 2006, p.131). During this time neutrophils and macrophages rush to the site and begin to attack any foreign bodies (Government, 2009). Proliferation phase starts around postoperative day 2-3. This is when the fibroblasts begin to replace the fibrin rich matrix that was placed during the lag phase (Mulholland and Doherty, 2006, p.130). Epithelialization and

When injury occurs, the body goes through different phases in order to complete its recovery, each phase has a specific job with the intention of preparing the body for the next phase of recovery. The phases that the body goes through are; the bleeding phase, the inflammatory phase, the proliferation phase and the remodelling phase, each of these phases happen at a specific time within the recovery after the injury. The phase that this essay is going to look at is the inflammatory phase and what role the inflammation has in tissue healing whilst briefly discussing what impacts it will have in a clinical setting.