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Chapter 13.14 : Microbiological Assessment of Orthopedic Surgery Sites
The severe morbidity associated with infection following implantation of orthopedic prosthetic devices or repair of bone fractures at septic trauma sites requires early and accurate microbiological assessment of these sites for successful management. Although no procedural or interpretive standards for culture of these sites have been established, the following is a set of procedures often used by surgical teams to assess microbial load or, along with other laboratory findings, to confirm the presence of an infection. These procedures include (i) enumeration of bacteria in tissue from a contaminated trauma site prior to repair of fracture, (ii) intraoperative culture of a site selected for implantation of a prosthesis, (iii) culture of fluid removed from the joint, and (iv) intraoperative culture of a failed prosthesis site.