Infected prosthesis: how to prevent a new infection

Good morning,

Three years ago my wife underwent a surgery for a prosthesis revision after an explant and two spacers. Prior to this, she had submitted to dozens of under endoscopy samples to ascertain the absolute wound healing.

On November 8 she underwent an L4, L5 lamino- and L4-L5_S1 recessotomy surgery. On November 20 she moved to the rehabilitation department and some infection signs appeared in the wound: the CRP increased from 56 to 163.

Since then it always dropped until 9.2 at the end of January, thanks to the virologist’s antibiotic treatment, that still continues today. After the visit of the surgeon who operated her, she started perceiving pain and the knee started to swell.

I kindly ask you if your treatment can be useful to avoid a potential prosthesis re-infection.

Waiting for your reply, I thank you in advance for your advice.

Best regards.

One comment on “Infected prosthesis: how to prevent a new infection

  1. Claudia Rastelli on

    Dear Ruggero,
    I suggest that you undergo a new orthopaedic advice by your specialist so that he examines your new clinical picture. Then, you will need to subject yourself to specific exams to evaluate the presence of a potential new infection in the prosthesis: haematochemical exams and NMR with contrast medium or scintigraphy with marked leukocytes. If your wife is currently under antibiotics, the exams must be repeated once the drugs suspended.

    In case of infection, you can undergo the first cycle of hyperbaric therapy before undergoing the surgical cleaning in order to reduce the bacterial load and define the infection site. You can undergo another cycle after the surgery to complete the cleaning in combination with specific antibiotics. Moreover, the hyperbaric therapy facilitates the trophism of the skin and soft tissues that underwent several surgeries in order to stimulate these tissues to a correct healing.

    Unfortunately, if there are bacteria on site, a “preventive” treatment is only preparatory to a surgical cleaning or palliative when the clinician doesn’t recommend a new surgery.

    I wish you all the best.
    Best regards,
    Dr Claudia Rastelli
    Degree in Medicine and Surgery at the University of Ferrara
    Subscribed to the Medical Council of Rimini, Number 2074


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