Clinic and Ortho On Call are in suite 100.Due to severe allergies of patients and staff, please do not wear scented perfumes, colognes, or lotions to your appointment.Due to COVID-19, only minor patients, patients with limited mobility, or those with extenuating circumstances may have guests at clinic appointments.Bring any splint, brace, or other types of medical device you may have for your injury.Wear loose, comfortable clothing that allows access to your injury or area in pain.You are welcome to wear a mask, and if you ask the staff and providers who work with you will wear a mask as well. Bring your insurance card and government-issued photo ID.Plan to arrive 15 minutes before your scheduled appointment to allow time for traffic and paperwork, and to prevent long waits.The microbiology MDT offers a robust way to facilitate antibiotic choice and delivery, and clinical correlation.To make your appointment as efficient as possible, please follow these guidelines: Recommendation: Although small numbers, the DAIR procedure seems to work well to prevent patients with infected arthroplasty requiring a revision operation. 12 out of 14 patients are off antibiotics completely. 1 patient had a subsequent manipulation under anaesthetic for stiffness. 1 patient underwent subsequent revision arthroplasty. 1 patient required a repeat DAIR procedure, and 1 had a further debridement. 11 patients treated with a DAIR had no further open procedures. Oral antibiotic regimes after this were variable, with 6 patients having no oral antibiotics and the remainder receiving between 4 weeks and 2 having lifelong antibiotic suppression. 13 out of 14 patients received at least six weeks of IV antibiotics. Isolated organisms included 8 streptococcus species, 4 staphylococcus species, and 1 enterococcus species. Mean time from diagnosis to DAIR was 2.3 days (not including a single outlier of 8 days). Mean highest pre-DAIR CRP was 197 (60-347) to mean baseline post-DAIR CRP of 7.65 (0.5-18). All had open debridement, washout and exchange modular components, and 12 had antibiotic beads inserted. 5 were early infections, 3 delayed, and 6 late infections. Results: A total of 14 DAIR procedures were performed (8 TKRs, 4 THRs, 1 UKR and 1 revision TKR) as recorded by the microbiology MDT in the time period. An Excel spreadsheet was created and populated with data from iCM, PACS and patient notes. Method: A list of all patients undergoing DAIR from January 2017 to now was obtained from the microbiology MDT dynamic spreadsheet. We, therefore, present a thorough review of literature for role of the DAIR procedure as a treatment option for infected TKA. This provided a system by which antibiotic regimens could be initiated and altered, outpatient antibiotics delivered, and clinical response to treatment assessed. consists of various retrospective series both in Orthopaedic and Microbiology journals with variable opinions over each aspect of DAIR. A microbiology MDT was set up to facilitate the management of patients with bone and joint infections to include an infectious disease and OPAT consultant, OPAT pharmacist and orthopaedic consultant. Interventions include antibiotics, single-stage revision, two-stage revision, arthrodesis or amputation, or DAIR (debridement, antibiotics and implant retention). Introduction: Infection is a recognised but challenging complication of primary hip and knee arthroplasty. DAIR to be different: The Derby experienceĪ baseline audit into use of DAIR to treat infected joint arthroplasties
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |