Fracture-related infection.
T Fintan MoriartyWillem-Jan MetsemakersMario MorgensternMarloes I HofsteeAlejandro Vallejo DiazJames E CassatBritt WildemannMelissa DepypereEdward M SchwarzRobert Geoffrey RichardsPublished in: Nature reviews. Disease primers (2022)
Musculoskeletal trauma leading to broken and damaged bones and soft tissues can be a life-threating event. Modern orthopaedic trauma surgery, combined with innovation in medical devices, allows many severe injuries to be rapidly repaired and to eventually heal. Unfortunately, one of the persisting complications is fracture-related infection (FRI). In these cases, pathogenic bacteria enter the wound and divert the host responses from a bone-healing course to an inflammatory and antibacterial course that can prevent the bone from healing. FRI can lead to permanent disability, or long courses of therapy lasting from months to years. In the past 5 years, international consensus on a definition of these infections has focused greater attention on FRI, and new guidelines are available for prevention, diagnosis and treatment. Further improvements in understanding the role of perioperative antibiotic prophylaxis and the optimal treatment approach would be transformative for the field. Basic science and engineering innovations will be required to reduce infection rates, with interventions such as more efficient delivery of antibiotics, new antimicrobials, and optimizing host defences among the most likely to improve the care of patients with FRI.
Keyphrases
- bone mineral density
- healthcare
- public health
- minimally invasive
- gene expression
- physical activity
- oxidative stress
- clinical practice
- patients undergoing
- palliative care
- risk factors
- surgical site infection
- quality improvement
- stem cells
- pain management
- trauma patients
- acute coronary syndrome
- mesenchymal stem cells
- bone marrow
- wound healing
- bone loss
- bone regeneration