Revision involves removal of the prosthetic and associated cement, followed by aggressive debridement, parenteral antibiotics, and placement of a new prosthesis.
In most cases, dressings that will adequately drain the cavity and promote granulation are sufficient, however in extreme cases it may be necessary to surgically lay open the wound to properly treat the wound. Table of Contents Alerts.
Trevor J. He has not had any fevers, chills, or systemic signs of infection. The following section includes additional WoundSource.
Lee, J. Acute infections are most commonly caused by virulent bacterial strains and occur within the first three months of recovery—often accompanied by warmth, pain, and erythema at the site of infection, along with constitutional symptoms.
Treatment of tunneling wounds is typically focused on treating the cause of the tunneling.
Surgical revision remains the gold standard of care in patients who develop PJI following THA and is the only route to reliably clear an underlying infection. The patient voluntarily discontinued antibiotic suppressive therapy AST after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection PJI , including recovery of his left-sided draining sinus tract.
Opening up the wound in this way makes it easier to properly clean the wound and helps prevent the wound edges from closing too early and forming another abscess. A tunneling wound or sinus tract is a narrow opening or passageway underneath the skin that can extend in any direction through soft tissue and results in dead space with potential for abscess formation.
Kuiper, R. When probing the wound, avoid cotton-tipped swabs and applicators as these can leave fibers in the wound.
Figure 1: X-ray demonstrates good fixation of implant without loosening, some eccentric wear on the right polyethylene liner, no periosteal reaction. To receive news and publication updates for Case Reports in Orthopedics, enter your email address in the box below. Das, M. Elliott, and R.