Abstract
Purpose
Hidden infections in a reconstructive surgery program are frequently underestimated.
Methods
A retrospective study was undertaken of 1,891 civilian war-wounded patients from Iraq, Syria, Yemen and Gaza treated in Amman from August 2006 to January 2016. One thousand three hundred and fifty-three underwent surgical interventions for previous bone injury and had systematic bone cultures.
Results
Among patients (167) without any clinical, biological or radiological signs of infection, 46% demonstrated infection based on bone cultures. We conclude that bone culture should become a prerequisite for any reconstruction in such contexts.
Similar content being viewed by others
References
Fakri RM, Al Ani AM, Rose AM, Alras MS, Daumas L, Baron E et al (2012) Reconstruction of nonunion tibial fractures in war-wounded Iraqi civilians, 2006–2008: better late than never. J Orthop Trauma 26(7):76–82
Murphy RA, Ronat J-B, Fakhri RM (2011) Multidrug-resistant chronic osteomyelitis complicating war injury in Iraqi civilians. J Trauma 71(1):252–254
Mader JT, Ortiz M, Calhoun JH (1996) Update on the diagnosis and management of osteomyelitis. Clin Podiatr Med Surg 13(4):701–724
Wilson ML, Winn W (2008) Laboratory diagnosis of bone, joint, soft-tissue, and skin infections. Med Microbiol 46(3):453-457
Mackowiak PA, Jones SR, Smith JW (1978) Diagnostic value of sinus-tract cultures in chronic osteomyelitis. JAMA 239(26):2772–2775
Senneville E, Melliez H, Beltrand E et al (2006) Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis 42:57–62
Ochsner PE, Bornes O et al (2014) Infections of the musculoskeletal system, basic principles, prevention, diagnosis and treatment. Heraeus Medical, Hanau, pp 84–85
Tong MJ (1972) Septic complications of war wounds. JAMA 219:1044–1047
Yun HC, Murray CK, Roop SA, Hospenthal DR, Gourdine E, Dooley DP (2006) Bacteria recovered from patients admitted to a deployed U.S. military hospital in Baghdad, Iraq. Mil Med 171:821–825
Howard CB, Einhorn M, Dagan R, Yagupski P, Porat S (1994) Fine needle bone biopsy to diagnose osteomyelitis. J Bone Joint Surg (Br) 76(2):311–314
Zuluaga AF, Galvis W, Jaimes F, Vesga O (2002) Lack of microbiological concordance between bone and non-bone specimens in chronic osteomyelitis: an observational study. BMC Infect Dis 2:8
Teicher CL, Ronat J-B, Fakhri RM, Basel M, Labar AS, Herard P, Murphy RA (2014) Antimicrobial drug–resistant bacteria isolated from Syrian war–injured patients, August 2011-March 2013. Emerg Infect Dis 20 (11):1949-1951
Teicher C, Foote NL, Al Ani AMK, Alras MS, Alqassab SI, Baron E, Ahmedd K, Herard P, Fakhri RM (2014) The short musculoskeletal functional assessment (SMFA) score amongst surgical patients with reconstructive lower limb injuries in war wounded civilians. Injury 45:1996–2001
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Funding
There is no funding source.
Studies with human participants or animals
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Hérard, P., Boillot, F. & Fakhri, R.M. Bone cultures from war-wounded civilians in the Middle East: a surgical prospective. International Orthopaedics (SICOT) 41, 1291–1294 (2017). https://doi.org/10.1007/s00264-016-3382-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-016-3382-1