9 research outputs found
Unilateral or bilateral V-Y fasciocutaneous flaps for the coverage of soft tissue defects following total knee arthroplasty
<p>Abstract</p> <p>Background</p> <p>Soft tissue necrosis following total knee arthroplasty (TKA) may be the cause of the devastating complication of deep infection. It necessitates an immediate operative intervention because it could potentially jeopardise the arthroplasty or even the limb.</p> <p>Methods</p> <p>Sixteen consecutive patients with a mean age of 73,8 years (range 47 to76 years) over a 6-year period (January 2003 to December 2008) with wound dehiscence after TKA were enrolled in the present study. Unilateral or bilateral fasciocutaneous V-Y flaps that are differently oriented, depending on the local conditions of the tissues were used to reconstruct the soft tissues defects.</p> <p>Results</p> <p>In 15 of the 16 cases studied, the wound was successfully covered with the presented technique while in 1 patient a partial flap loss occurred, which was healed after surgical debridement and the application of vacuum system. No other complications occurred. Knee prosthesis was salvaged in all the patients with a good functional and esthetical outcome.</p> <p>Conclusions</p> <p>The presented reconstructive technique is a simple, quick, versatile and reliable solution for the coverage of soft tissue defects following TKA, more than 2 cm width and grade 1 and 2 according to Laing classification, provided the V-Y flaps are applied early in the postoperative period and no complex defects are involved.</p
Experimental Osteomyelitis Caused by Methicillin-Resistant Staphylococcus aureus Treated with a Polylactide Carrier Releasing Linezolid
Background: The effectiveness of a new delivery system consisting of
polymerized dilactide (PLA) with incorporated linezolid was investigated
in a rabbit model as a means of treating methicillin-resistant
Staphylococcus aureus (MRSA) osteomyelitis.
Methods: The PLA-linezolid system was prepared after thorough stirring
of PLA with linezolid at a 10: 1 ratio. Experimental osteomyelitis was
established in 40 rabbits by a modification of the Norden model with
MRSA as the test isolate. After a hole had been drilled in the upper
right femur, the isolate was inoculated using a thin needle working as a
foreign body. At three weeks, the needle was removed and cultured, and
the PLA-linezolid system was implanted in half the animals (group B);
the remaining half was the control group (group A). Animals were
sacrificed at regular intervals; tissue around the site of implantation
was examined for pathologic changes and cultured quantitatively.
Results: The prepared system eluted linezolid in vitro at concentrations
much greater than the minimum inhibitory concentration (MIC) of the test
pathogen for 11 days. At three weeks after inoculation of the test
isolate, all animals had osteomyelitis. By the sixth week, bacterial
growth from cancellous bone of group B was significantly lower than that
in group A. However, this effect was not maintained until the end of the
study (weeks 8 and 10), when the differences in bacterial growth in the
two groups were not significant.
Conclusion: Polymerized dilactide mixed with 10% linezolid achieved
partial arrest of the offending pathogen in an experimental model of
osteomyelitis caused by MRSA