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Microbiology for orthopaedic surgeons: selected aspects.

The treatment and prevention of orthopedic sepsis is based on the principles of any surgical sepsis and the factors that influence the chronicity of infection and microbiology. In the past, the field of orthopedic sepsis has been neglected and has retained the methodologies of previous years without a sharp focus on the principles and pathophysiology of infectious disease. Over the last ten years there has been an increasing interest in orthopedic sepsis along with significant changes in our concepts of antibiotics, principles of treatment, and microbiology. In this article the authors hope to identify the practical uses of clinical microbiology in diagnosing and managing orthopedic infections. The surgeon can use microbiologic techniques in many ways: (a) to determine sterility of wounds, (b) to detect the presence of infection, (c) to estimate the timing of primary closure of acute and chronic wounds and the application of skin grafts, and (d) as guides for the surgeon and infectious disease physician in the choice of appropriate antibiotics.