THE USE OF QUANTITATIVE BACTERIOLOGICAL ASSESSMENT OF BONE

The purpose of this paper was to examine whether quantitative bacterio logic assessment of hone is a reliable indicator of the adequacy of de bridement of draining wounds involving bone. This is a retrospective r eview of 31 consecutive patients treated for draining posttraumatic/su rgical wounds involving bone. Nineteen patients met the necessary crit eria and were included in the study. These patients underwent radical debridement of bone and soft tissue, intraoperative assessment of the debrided wound by rapid slide quantitative bacteriologic assessment, a nd closure with well-vascularized tissue. Clinical assessment of vascu larity and rapid slide quantitative bacteriologic assessment of cancel lous bone and soft tissue were the only prerequisites used in determin ing the appropriateness of wound closure in this study. At the time of most recent followup, none of the 19 patients had recurrent wound dra inage. Two patients required a second procedure to partially elevate t heir flaps and drain recurrent soft-tissue infections. None of the pat ients had recurrence of bony infection. Seventeen patients who present ed initially with fractures or osteotomies all had successful hone uni ons. This study demonstrates that the technique of rapid slide quantit ative bacteriologic assessment of cancellous bone is a useful adjunct to surgical judgment and allows one to close draining wounds (frequent ly with complex wound closure options) with a high level of confidence .