infection

Complications

Aetiology

 

Undisplaced wrist fracture

- interrupts blood supply at a watershed area

- between 3 weeks and 3 months post injry

 

Spontaneous

- RA / SLE

 

Site

 

Just distal to extensor retinaculum at Lister's tubercle

 

Examination

 

Place hand flat on table

- lift only thumb

 

Management

 

Management

Incidence

 

Knee > Hip

- superficial position

- limited cover of well vascularised muscle 

- watershed area of skin blood supply anterior to the skin incision 

- much increased in fully constrained prosthesis 

 

Ideal < 1%

 

Risk Factors

 

Increased with

- revision

- prior infection

- RA / Psoriatic arthropathy

- DM

Prevention

Preoperative

 

Identify high risk groups

- immunocompromised

- diabetes

- RA

- malnutrition

 

Urine screen

- check for and treat UTi

 

Groin, nose, axilla swabs

- for MRSA

- if positive, treat

- need 3 consecutive free swabs

 

3 x chlorhexidine preoperative showers in 8 hours

 

Admit day of surgery

- check skin for lesions

Subscribe to infection