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

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 str...

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Autores principales: Rupp, Markus, Walter, Nike, Popp, Daniel, Hitzenbichler, Florian, Heyd, Robert, Geis, Sebastian, Kandulski, Melanie, Thurn, Sylvia, Betz, Thomas, Brochhausen, Christoph, Alt, Volker
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9952612/
https://www.ncbi.nlm.nih.gov/pubmed/36830141
http://dx.doi.org/10.3390/antibiotics12020230
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author Rupp, Markus
Walter, Nike
Popp, Daniel
Hitzenbichler, Florian
Heyd, Robert
Geis, Sebastian
Kandulski, Melanie
Thurn, Sylvia
Betz, Thomas
Brochhausen, Christoph
Alt, Volker
author_facet Rupp, Markus
Walter, Nike
Popp, Daniel
Hitzenbichler, Florian
Heyd, Robert
Geis, Sebastian
Kandulski, Melanie
Thurn, Sylvia
Betz, Thomas
Brochhausen, Christoph
Alt, Volker
author_sort Rupp, Markus
collection PubMed
description 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.
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spelling pubmed-99526122023-02-25 Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center Rupp, Markus Walter, Nike Popp, Daniel Hitzenbichler, Florian Heyd, Robert Geis, Sebastian Kandulski, Melanie Thurn, Sylvia Betz, Thomas Brochhausen, Christoph Alt, Volker Antibiotics (Basel) Article 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. MDPI 2023-01-21 /pmc/articles/PMC9952612/ /pubmed/36830141 http://dx.doi.org/10.3390/antibiotics12020230 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rupp, Markus
Walter, Nike
Popp, Daniel
Hitzenbichler, Florian
Heyd, Robert
Geis, Sebastian
Kandulski, Melanie
Thurn, Sylvia
Betz, Thomas
Brochhausen, Christoph
Alt, Volker
Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title_full Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title_fullStr Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title_full_unstemmed Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title_short Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome—A Retrospective Case Control Study at a Tertiary Referral Center
title_sort multidisciplinary treatment of fracture-related infection has a positive impact on clinical outcome—a retrospective case control study at a tertiary referral center
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9952612/
https://www.ncbi.nlm.nih.gov/pubmed/36830141
http://dx.doi.org/10.3390/antibiotics12020230
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