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J Am Acad Orthop Surg, Vol 14, No 10, September 2006, S105-S110.
© 2006 the American Academy of Orthopaedic Surgeons
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Treatment of Chronic Infection

George Cierny, III, MD and Doreen DiPasquale, MD

Dr. Cierny is Senior Consultant, REOrthopaedics, Inc, San Diego, CA. Dr. DiPasquale is Senior Consultant, REOrthopaedics, Inc.

Dr. Cierny has received research or institutional support from Orthofix, Inc; nonincome support (such as equipment or services), commercially derived honoraria, or other non-research–related funding (such as paid travel) from Smith & Nephew; and royalties from Wright Medical Technology. Dr. DiPasquale has received nothing of value nor owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Reprint requests: Dr. Cierny, REOrthopaedics, Suite 120, 7910 Frost Street, San Diego, CA 92123.

Failure of an acute inflammatory response to resolve a wound infection heralds a cascade of events that affects the host and pathogens, culminating in a chronic, refractory condition. The factors contributing to this outcome include immune compromise of the host, antimicrobial resistance, wound-healing deficiencies, and the adherence of pathogens to themselves and wound surfaces via an impenetrable, resistant biofilm. To eradicate chronic infection, the pathogens, biofilm, surfaces available for adherence, and compromised tissue must be removed.






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Copyright © 2006 by the American Academy of Orthopaedic Surgeons.