Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center

Author:

Rupp Markus1ORCID,Walter Nike12ORCID,Popp Daniel1ORCID,Hitzenbichler Florian3,Heyd Robert4,Geis Sebastian5,Kandulski Melanie6,Thurn Sylvia7,Betz Thomas8,Brochhausen Christoph910ORCID,Alt Volker1ORCID

Affiliation:

1. Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany

2. Department for Psychosomatic Medicine, University Hospital Regensburg, 93053 Regensburg, Germany

3. Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany

4. Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany

5. Center of Plastic and Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany

6. Department of Internal Medicine I, University Hospital Regensburg, 93053 Regensburg, Germany

7. Institute of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany

8. Department of Vascular Surgery, University Hospital Regensburg, 93053 Regensburg, Germany

9. Institute of Pathology, University Regensburg, 93053 Regensburg, Germany

10. Institute of Pathology, University Medical Center, 68167 Mannheim, Germany

Abstract

Objectives: Fracture-related infection (FRI) is a major complication in orthopedic and trauma surgery. The management and choice of treatment can be difficult depending on multiple factors. Therefore, we implemented a weekly multidisciplinary team discussion to determine diagnostic and treatment strategies in FRI patients and aimed to analyze its effect on clinical outcomes. Methods: Clinical outcomes of FRI patients treated before and after implementation of a structured multidisciplinary treatment (MDT) approach with a weekly case discussion were compared at a follow-up of 12 months. Results: In total, n = 117 were eligible for enrolment, whereby n = 58 patients (72.4% male, mean age 56.7 ± 16.8 years) constituted the MDT group and n = 59 patients (72.9% male, mean age 55.0 ± 16.5 years) the control group. In the MDT group more cases were treated with local antibiotics (67.2% vs. 27.1%, p < 0.001) and significant less amputations (3.4% vs. 6.8%, p = 0.014), as well as less revision surgeries (1.5 ± 1.2 (0–5) vs. 2.2 ± 1.2 (0–7), p = 0.048) were performed. A trend towards less debridement, antibiotics and implant retention (DAIR) procedures, lower rates of recurrence of infection and less treatment failures in the MDT group was observable, even though not statistically significant. Conclusion: An MDT approach providing a patient tailored treatment concept in the treatment of FRI patients appears to be beneficial for the affected patients. Quality and efficacy of implemented MDT meetings should further be evaluated to provide sufficient evidence to further implement this valuable tool in clinical practice and decision making.

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3