ABSTRACT
Background: Open fractures are a challenging condition to treat because they are frequently compounded by infection and nonunion. Traditional bone defect care strategies are mostly focused on fracture union rather than infection prevention. The goal of this study is t o use the Masquelet approach to examine the outcome of a post - traumatic defect with infection in long bones. This method is a two - step process. Stage I surgery includes debridement and the placement of an antibacterial spacer in the bone defect. Stage II s urgery involved removing the spacer while preserving the induced membrane that had grown on the spacer's surface and filling the bone - gap with morselized iliac crest bone - graft within the membrane sleeve. Methods: There were 22 patients in this study (18 m ales and 4 females), all of them had infected long bone fractures with a bone defect. The average length of the bone defect was 3.5 centimetres. The duration of follow - up varied from 6 to 15 months. Results: After an average of 11.5 weeks following the fir st step of surgery, radiological union was achieved. After stage 1, no patient had any remaining infection. After radiological union, all of the patients were able to mobilise with full weight bearing and a satisfactory range of motion in the adjoining joi nts. Conclusion: With favourable outcomes, this treatment can be used on infected fractures with bone loss on a regular basis. Antibiotic cement spacers, used in conjunction with complete debridement, minimise the risk of infection. The graft is revascular ized through induced biomembrane. In most circumstances, union may be predicted; nonetheless, the length of time it takes to reach an agreement is a constraint. The technique is low - cost and does not necessitate any additional training or equipment. Despit e the fact that it is a two - stage procedure, it does not necessitate several surgeries as in traditional approaches.
ABSTRACT
A prospective study was carried out on patients with diabetic foot lesions to determine their clinical characteristics, the spectrum of aerobic microbial flora and to assess their comparative in vitro susceptibility to the commonly used antibiotics. A total of 157 organisms (143 bacteria and 14 fungi) were isolated and an average of 1.52 isolates per case was reported. Polymicrobial infection was found in 35% of the patients. In this study, Pseudomonas aeruginosa among the gram-negative (22%) and Staphylococcus aureus among the gram-positive (19%) were the predominantly isolated organisms, while Candida was the most predominantly isolated fungus. Antimicrobial sensitivity pattern of the isolates is discussed in detail. There was a linear increase in the prevalence of organisms with increase in Wagner's grade. Neuropathy (76%) and peripheral vascular disease (57.28%) was a common feature among the patients. Poor glycemic control was found in 67% of the patients. Awareness about lower limb complications of diabetes was very low (23%) among the patients.