Approaches to surgical treatment and antibacterial therapy in patients with chronic infection after war injuries

Authors

  • Andrej Trampuz Biofilm Research Laboratory Center for Musculoskeletal Surgery Charite–Universitatsmedizin, Berlin. Germany, Germany
  • Olga Pidgaiska Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-5025-977X
  • Volodymyr Filipenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5698-2726
  • Kostiantyn Romanenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-1639-8274
  • Olexii Marushchak Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-5606-8763

DOI:

https://doi.org/10.15674/0030-59872023362-68

Keywords:

Infection, antibiotic therapy, combat trauma

Abstract

Fracture-related infection following orthopedic surgery, especially in cases of war-related trauma, represents a grave complication. The injuries sustained in war often entail severe damage to soft tissues, including significant impairment of vessels, nerves, tendons, muscles, and result in substantial bone defects. Complicating matters further, these infections often involve multidrug-resistant pathogens, making effective treatment a significant challenge. Optimal management of patients with combat-related trauma and signs of infection necessitates specialized care in dedicated centers. The approach to treatment should be guided by a well-defined algorithm that incorporates appropriate surgical interventions alongside systemic and localized antibiotic administration. In instances where chronic infection manifests after war-related injuries and specific causative agents are not definitively identified, initiating empiric therapy is advisable. A combination of meropenem, colistin, and vancomycin can be a suitable choice for initial treatment. Subsequently, once the causative microbes are identified, targeted treatment can be prescribed based on the susceptibility patterns. This article delves into the primary pathogens commonly found in war-related wounds and provides effective antibiotic regimens based on the specific microorganisms. One promising approach for managing severe war injuries is suppressive antibiotic therapy, which enhances the prospects of successful treatment. The comprehensive strategy outlined
here aims to mitigate the serious risks posed by fracture-related infections in the context of war-induced trauma, ultimately improving patient outcomes and prognosis.

Author Biographies

Andrej Trampuz, Biofilm Research Laboratory Center for Musculoskeletal Surgery Charite–Universitatsmedizin, Berlin. Germany

MD, Prof.

Olga Pidgaiska, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD in Traumatology and Orthopaedics

Volodymyr Filipenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Orthopaedics and Traumatology

Kostiantyn Romanenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD in Traumatology and Orthopaedics

Olexii Marushchak, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD

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How to Cite

Trampuz, A. ., Pidgaiska, O. ., Filipenko, V. ., Romanenko, K. ., & Marushchak, O. . (2023). Approaches to surgical treatment and antibacterial therapy in patients with chronic infection after war injuries. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 62–68. https://doi.org/10.15674/0030-59872023362-68

Issue

No. 3 (2023)

Section

IN AID OF PRACTING DOCTOR. LECTURES

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