Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fracture Repair 2 > Dealing with Infectious Complications > Flashcards

Dealing with Infectious Complications Flashcards

1
Q

Infection during surgery is classed as..?

A

Iatrogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many infections are due to iatrogenic causes?

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of iatrogenic infections? (5)

A

Contaminated implant

Break of sterility

Long surgery (90-minute rule)

Sequestrum (Necrotic bone)

Loose implant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 types of ORIGIN for infection?

A

At the time of trauma: open contaminated fracture.

During hospitalisation (nosocomial): infection picked up in the hospital.

Skin

Haematogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is haematogenous infection as a result of?

A

another infection foci in the body as cystitis, otitis, gengivitis, bite wounds, enteritis, dermatitis, prostatitis, endometritis etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Possible causes of bacteraemia? (7)

A

Prostatitis
Cystitis
Enteritis
Bite wounds
Gingivitis
Otitis
Discospondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

After diagnosing a superficial infection, what will be your next step?

A

Deep aspirate via aseptic technique for cytology and culture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How long to administer ABx for?

A

According to culture and sensitivity and/or clinical audit for 7-14 days for superficial infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

To treat and diagnose deep surgical site infection will require sedation or general anaesthesia (GA) of the patient, What 4 things need to be done under the anaesthetic?

A
  • Xrays
  • Samples
  • ABx
  • Fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why take xrays for deep infections?

A

Assess stability.
If unstable - corrective sx needed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why do you not take samples from only draining sinus of deep infection?

A

Skin commenal contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Deep infections - what should samples be sent for? (2)

A

C+S
AND cytology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the antibiotic of choice for deep infect? Dose? Route?

A

Post sampling start broad-spectrum bactericidal antibiotics, whilst waiting for culture and sensitivity (C+S). Dose at the top of the dose range, unless you have a specific reason not to. Preferable to start with 24 hours of intravenous treatment then move to oral treatment if the animal is eating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is fluid therapy appropriate for deep infect?

A

Administration of intravenous fluid therapy is necessary if the patient is inappetent or has systemic signs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Following initiating treatment for deep infection; when would you expect improvement?

A

24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is surgical debridement indicated? (2)

A

If there is no response to medical therapy

If there is clinical deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Deep infection; how long to treat for? When should a 2nd culture be taken?

A

4-6 weeks

second culture 5 days post completion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why remove implant after a # has healed with a deep infection?

A
  • Avoid reoccurrence due to biofilms around implant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define osteomyelitis

A

inflammation of the bone cortex and the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is osteomyelitis often caused by?

A

Introduction of bacteria during orthopaedic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T or F
Healthy bone is relatively resistant to infection

A

True

22
Q

What about orthopaedic surgery creates favourable environment for bacterial colonisation and multiplication? (3)

A
  • Metal implant
  • Haematoma
  • Necrotic tissue
23
Q

Sufficient numbers of pathogenic bacteria can cause osteomyelitis if the cortical bone is..?

A

Avascular

24
Q

Acute osetomyelitis:
A) When does this occur in relation to surgery?
B) Clinical symptoms? (4)
C) Degree of lameness?
D) Are they systemically ill?

A

A) 2-3 weeks
B) Heat, swelling, pain
C) Varying
D) Occassionally

25
Q

Chronic osteomyeltitis:
A) When does it occur?
B) Are they systemically ill?

A

A) Several months
B) Uncommon - therefore difficult to diagnose!

26
Q

What is a common complication of chronic osteomyelitits?

A

A sequestrum

27
Q

What is a sequestrum?

A

infected, avascular cortical bone

28
Q

What increases the likihood of osteomyelitits? (5)

A

excessive trauma to soft tissues
periosteal stripping
devascularisation
fracture instability
altered local defence

29
Q

How to diagnose osteomyelitis? (3)

A
  • History
  • Clinical signs
  • Radiography
30
Q

What is often seen on xray with acute osteomyelitis?

A

Soft tissue swelling

31
Q

What is possibly seen on x ray with chronic osteomyelitis? (6)

A

Bone lysis
Periosteal new bone
Cortical thinning,
involucrum
sequestrum
delayed union or non-union of the fracture.

32
Q

What is an involucrum?

A

Sclerotic bone surrounding sequestrum

33
Q

Are most infections poly or monocrobial?

A

Mono

34
Q

Bacteria causing surgical infections:
A) 40%
B) 40%
C) 20%

A

40% - Staphylococcus spp. (Staph. Intermedius and aureus most commonly)
40% - mixed gram negative
20% - anaerobes

35
Q

What mycosis have both been reported as causing long bone osteomyelitis in dogs and cats in Great Britain? (2)

A

Cryptococcus & Aspergillus

36
Q

How to treat acute osteomyeltitis. (4)

A

The presence of loose implants necessitates revision surgery.

Antibiotic administration (broad spectrum at first instance).

Bacterial culture either needle aspiration or during surgical revision (such as at the end of debridement), followed by antibiotic sensitivity test. Minimum duration of antibiotic course should be 4-6 weeks.

If patient fail to respond to treatment, surgical debridement and implantation of antibiotic loaded beads or bone cement may be required.

37
Q

How to treat chronic osteomyeltitis. (5)

A

Surgical debridement and lavage and/or implant removal or revision surgery.

Identification of sequestrum and removal if present.

Surgical drain can be placed but care needs to be taken as this can create a route of infection). Alternatively, the wound can be left to healing by second intension.

Regular bacterial swab for culture and sensitivity.

Antibiotic loaded beads or bone cement.

38
Q

What ABx for anaerobes can be given initially and modified depending on bacterial culture/sensitivity result?

A

Cephalexin, amoxicillin/clavulanate ± metronidazole

39
Q

How to prevent risk of infection? (3)

A

Good theatre practice
Surgical technique.
Perioperative antibiotics should be given intravenously 30–60 minutes before surgical incision and continued for up to 24 hours

40
Q

When to clip for GA to reduce infection?

A

Do not clip before anaesthesia as early clipping increases the infection risk.

41
Q

What surgical clothing for aseptic practice? (5)

A

Gloves
Hat
Mask
Gown
Disposable drapes

42
Q

Perioperative ABx?

A

Up t 24 hours max

43
Q

What surgical Abx of choice?

A

Cefuroxime
Potentiated amoxicillin

44
Q

How do S/C ABx result in an increased chance of a delayed resistant infection?

A

does not reach therapeutic concentrations during surgery

45
Q

How can suture reduce infection:
A) Type
B) Size?

A

A) AVOID non absorable + Braided
B) Smallest size and minimum amount

46
Q

Which of these have a higher infection rate
Stainless steel vs titanium

A

Stainless steel

47
Q

What about surgery to minimise infection? (3) - Other than strerility

A
  • gentle handling
  • close dead space
  • Short surgery time
48
Q

What should be done before closure?

A

Lavage

49
Q

How to keep a sterile barrier of the wound in hosp?

A

Primapore

50
Q

How to prevent animal contamination of wound?

A

B/C

51
Q

How to monitor infections?

A

Audits

Fracture Repair 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions