Autosterilization of Contaminated and Devascularized Bone Fragments Through a Subcutaneous Bone Pouch. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Lindvall, Eric; Martirosian, Armen; Morshed, Saam
• Is Part Of: Journal of orthopaedic trauma. Volume 29:Issue 12(2015)
• Publication Date: 2015-12
• Subjects: open fractures -- bone pouch -- auto sterilization -- devascularized bone fragments -- limb salvage -- bone deficits -- segmental bone loss -- trauma; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000352
• Languages: English
• ISSNs: 0890-5339

Abstract

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. Abstract : Supplemental Digital Content is Available in the Text.