- Author
-
F.R.K. Sanders
- Title
- Foot ankle trauma surgery
- Subtitle
- Prevention of surgical site infections and patient reported outcome
- Supervisors
- Co-supervisors
-
T. Schepers
- Award date
- 5 November 2020
- Number of pages
- 193
- ISBN
- 9789463809825
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
In the first part of this thesis the incidence of surgical site infections is studied in different trauma surgical procedures. Surgical site infections are evaluated as a complication of syndesmotic screw removal and after surgically treated calcaneal fractures. Moreover, the effect of season of surgery on the number of surgical site infections is investigated. In the second part the influence of prophylactic antibiotics on surgical site infections in foot ankle trauma surgery is further explored. This includes variations in dose and the resulting measured concentrations of antibiotics in different parts of the body. Moreover, the protocol of a randomized controlled trial studying the effect of 2g of cefazolin on infections after implant removal is described. The final part focusses on patient reported outcome after foot ankle surgery. This sections shows that implant removal is not necessarily beneficial when it comes to functional outcome and quality of life. Combined with the relatively high rate of surgical site infections after implant removal this leads to the conclusion that the individual indication for these procedures should be very carefully outweighed. In addition to functional outcome, malpractice claims are also evaluated as a tool indicating patient reported outcome. This last chapter shows that expectation management of the outcomes of primarily elective procedures is very important to avoid misunderstandings and dissatisfied patients.
- Persistent Identifier
- https://hdl.handle.net/11245.1/98cc984f-730b-47da-85fb-296b09aaec05
- Downloads
-
Thesis (complete)
Front matter
General introduction; Thesis outline
Chapter 1: Surgical site infections following syndesmotic screw removal; A systematic review
Chapter 2: Risk factors for surgical site infections with the sinus tarsi approach in displaced intra-articular calcaneal fractures: A prospective cohort study
Chapter 3: Seasonal effect on the incidence of post-operative wound complications after trauma-related surgery of the foot, ankle and lower leg
Chapter 4: Target site antibiotic concentrations in orthopedic/trauma extremity surgery: Is prophylactic cefazolin adequately dosed? A systematic review and meta-analysis
Chapter 5: Comparison of 2g vs 1g of prophylactic cefazolin in surgical site infections in trauma surgery below the knee
Chapter 6: Wound infection following implant removal of foot, ankle, lower leg and patella: Protocol of a randomized controlled trial investigating the (cost-)effectiveness of 2g of prophylactic cefazolin compared to placebo (WIFI-2 trial)
Chapter 7: Functional outcome of implant removal following fracture fixation below the level of the knee
Chapter 8: Functional outcome of routine versus on demand removal of the syndesmotic screw: A multicenter randomized clinical trial
Chapter 9: Claims in orthopaedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis
Thesis summary; Future perspectives; Nederlandse samenvatting; PhD portfolio; List of publications; Dankwoord; Curriculum vitae
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