Autosterilization of Contaminated and Devascularized Bone Fragments Through a Subcutaneous Bone Pouch.

Abstract:

OBJECTIVES:The purpose of this article was to present results of cases using a subcutaneous bone pouch technique and to assess the potential "autosterilization" effect that occurs when these contaminated free bone fragments are placed in nontraumatized tissue. DESIGN:Retrospective review of prospectively collected data. SETTING:Community-Based Level 1 Trauma Center. PATIENTS/PARTICIPANTS:Eight patients were consented for the described technique, and data were collected over an 8-year period. INTERVENTION:Placement of fragments into a surgically created subcutaneous pouch in a nontraumatized tissue zone, followed by delayed, cultured, and attempted reimplantation at the initial injury site. MAIN OUTCOME MEASUREMENTS:Culture results after extraction of bone fragments from subcutaneous bone pouch and clinical outcomes after reimplantation into initial open fracture site. RESULTS:All 8 cases undergoing this technique resulted in healing of the subcutaneous bone pouch without signs or symptoms of infection at the time of attempted reimplantation or fragment removal. Four of the 8 cases had successful reimplantation and union at the open fracture site. CONCLUSIONS:Preserving devascularized bone fragments in a subcutaneous pouch in a region of nontraumatized tissue appears to be a safe procedure that allows for an "autosterilization" type of process to occur. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

authors

Lindvall E,Martirosian A,Morshed S

doi

10.1097/BOT.0000000000000352

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

558-62

issue

12

eissn

0890-5339

issn

1531-2291

journal_volume

29

pub_type

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