Infection and perioperative orthopedic care

Abstract

The detection and treatment of infection are integral to orthopedic surgical and perioperative practice. Prevention, prompt diagnosis, and appropriate therapy are vital considerations. Risk factors for infection, some of which are modifiable, can be identified. Antimicrobial prophylaxis is of known benefit in spine and arthroplasty procedures and is commonplace in arthroscopy. Fever following orthopedic surgery is rarely from an infection and within the first 72 h most patients do not benefit from a fever workup. The management of the infected patient is rarely routine as patients present with varied symptoms, the microbiology is diverse and standard protocols for orthopedic infections need to be kept flexible. Empiric antibiotics without deep cultures are rarely indicated and early involvement of experienced personnel can optimize care of patients so afflicted.