Musculoskeletal infection

Antibiotic development is dwindling1

Musculoskeletal infections, including infected non-unions, osteomyelitis and periprosthetic joint infections, are one of the biggest healthcare challenges of the 21st century.

As the rapid growth of antibiotic-resistant strains and biofilms continues to outpace the development of new antibiotics and antibiotic strategies, care delivery is becoming increasingly challenging and complicated.1,2

The global increase of infections caused by antibiotic resistant bacteria such as the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) requires targeted antibiotic treatment.

  • In the EU, Norway and Iceland multidrug resistant (MDR) bacteria has an estimated economic loss of more than €1.5 billion each year.3
  • In the USA, the cost of antibiotic-resistant infections  to the health care system is $21 billion to $34 billion each year and more than 8 million additional hospital days.4

Surgical Site Infections

Surgical site infections (SSI) are a huge burden on hospital resources and annual expenditure.

  • In England, SSI account for approximately 16% of all healthcare associated infections.5
  • In the USA, SSI account for approximately 23% of hospital-acquired infections and cost up to $10 billion annually in direct medical expenses.6

Identifying the micro-organisms that cause the SSI is essential to ensure the appropriate antibiotic and treatment strategies are selected.

Distribution of micro-organisms causing SSI7

Periprosthetic joint infection (PJI)

A major cause of arthroplasty failure, PJI often leads to multiple surgical interventions, prolonged antibiotic therapy and higher costs.

In England, the estimated total cost associated with treating deep wound infection in TKR and THR is c. £100,000 per patient.8

  • 1% of primary hip and knee arthroplasties become infected.7
  • 16% of hip revisions are carried out due to infection.9
  • 23% of knee revisions are carried out due to infection.9

In the USA, the annual hospital cost of infected revisions is estimated to exceed $1.62 billion by 2020.10

Diabetic foot ulceration (DFU)

DFU is a major cause of lower-extremity amputations, with up to 24% of people with a DFU requiring amputation.11 Treatment for DFU carries considerable cost in terms of mortality and financial burden.

  • It is estimated that 40% of amputations could be prevented with appropriate wound care.12
  • Approximately 50% of patients who have foot amputations due to diabetes die within five years.13
  • In the USA, amputations in adults with diabetes account for about 60% of the amputations of legs and feet not resulting from an injury.14

Choosing an innovative void management device to work alongside your infection management strategy is key to:

  • Minimising avoidable complications
  • Improving outcomes
  • Reducing costs

Listed below are 4 of the most relevant articles for this specialty but there is much more unrivalled evidence to explore on our Library page.

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References and regulatory statements

1. Spellberg, B., et al., The Epidemic of Antibiotic-Resistant Infections: A Call to Action for the Medical Community from the Infectious Diseases Society of America. Clinical Infectious Diseases, 2008. 46(2): p. 155-164. 2. Gauland, C., Managing lower-extremity osteomyelitis locally with surgical debridement and synthetic calcium sulfate antibiotic tablets. Adv Skin Wound Care, 2011. 24(11): p. 515-23. 3. 4. Golkar, Z., Bagasra, O., Pace, D.. Bacteriophage therapy: a potential solution for the antibiotic resistance crisis. The Journal of Infection in Developing Countries, North America, 8, feb. 2014. 5.  Journal of infection prevention; May 2015, Vol.16 No.3:118-125 6. Shea KG et al. Surgical Site Infection Reduction Program: Challenges and Opportunities. J Pediatr Orthop. 2015 Jul-Aug;35(5 Suppl 1):S51-4. 7. Surveillance of Surgical Site Infections in NHS Hospitals in England. Report 2014/15 Surveillance_of_Surgical_Site_Infections_in_NHS_Hospitals_in_England_report_2014-15.pdf  8. A national review of adult elective orthopaedic services in England; Prof T. Briggs; March 2015. 9. NJR 13th Annual Report. 10. Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic Burden of periprosthetic joint infection in the United States. J Arthroplasty. 2008;23:984-91 11. American Podiatric Medical Association (APMA). Diabetic Wound Care. 2016. 12. Clayton, W. and T.A. Elasy, A Review of the Pathophysiology, Classification, and Treatment of Foot Ulcers in Diabetic Patients. Clinical Diabetes, 2009. 27(2): p. 52-58. 13.  14.

Note: See STIMULAN page for regulatory statements.