Orthopaedic Surgery/Soft Tissue Infections

Infection is an unfriendly encounter with a foreign organism. Lest we forget we live in harmony with many mico-organisms and one might even say that it is well that they occupy the niches they do lest a less pleasant neighbor move in. This is not to say that our normal flora are in all cases benign, but they tend to be opportunistic about it, so they keep our immune system on its toes. It is probably best after all that our immune mechanisms be exercised on a regular basis.

Acute infection may do us in and in some cases due entirely to the toxic products of the infecting organism. In other cases it is the immune response to the infection that can be nearly as lethal as seems to be the case it seems with H5N1 strain of influenza or birdflu.

As orthopedic surgeons we confront a number of different types of infection scenarios. First and foremost we are focused on avoiding infection which in the absence of specific measures of anti-sepsis would make much of what we do impractical, so it behooves us to do this optimally.

We are also asked to perform therapeutic interventions in the setting of established musculoskeletal infections and one of the most anxiety provoking is the soft tissue infection which we call necrotizing fasciitis also known more commonly by the general surgeons as synergistic gangrene. One can hardly imagine a more nefarious enemy, seemingly lurking everywhere and at the least provocation it seems producing a rapidly progressive infection which can kill an otherwise healthy human in a matter of hours.

http://www.ahrq.gov/clinic/ptsafety/chap20a.htm