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Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy

Overview of attention for article published in BMC Infectious Diseases, April 2018
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Title
Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy
Published in
BMC Infectious Diseases, April 2018
DOI 10.1186/s12879-018-3076-y
Pubmed ID
Authors

Johan Andrianasolo, Tristan Ferry, Fabien Boucher, Joseph Chateau, Hristo Shipkov, Fatiha Daoud, Evelyne Braun, Claire Triffault-Fillit, Thomas Perpoint, Frédéric Laurent, Alain-Ali Mojallal, Christian Chidiac, Florent Valour, on behalf of the Lyon BJI study group

Abstract

A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis. Sixty-four pressure ulcer-related pelvic osteomyelitis in 61 patients (age, 47 (IQR, 36-63)) were included. Osteomyelitis was mostly polymicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae spp. (44%) and anaerobes (44%). Flap coverage was performed after 7 (IQR, 5-10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5.8; p = 0.022). An increased prevalence of coagulase negative staphylococci (p = 0.017) and Candida spp. (p = 0.003) was observed at time of flap coverage. An ESBL Enterobacteriaceae spp. was found in 5 (12%) patients, associated with fluoroquinolone consumption (OR, 32.4; p = 0.005). Treatment duration was as 20 (IQR, 14-27) weeks, including 11 (IQR, 8-15) after reconstruction. After a follow-up of 54 (IQR, 27-102) weeks, 15 (23%) failures were observed, associated with previous pressure ulcer (OR, 5.7; p = 0.025) and Actinomyces spp. infection (OR, 9.5; p = 0.027). Pressure ulcer-related pelvic osteomyelitis is a difficult-to-treat clinical condition, generating an important consumption of broad-spectrum antibiotics. The lack of correlation between outcome and the debridement-to-reconstruction interval argue for a short sequence to limit the total duration of treatment.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 56 100%

Demographic breakdown

Readers by professional status Count As %
Other 9 16%
Student > Bachelor 8 14%
Student > Master 7 13%
Researcher 5 9%
Student > Ph. D. Student 4 7%
Other 6 11%
Unknown 17 30%
Readers by discipline Count As %
Nursing and Health Professions 14 25%
Medicine and Dentistry 12 21%
Pharmacology, Toxicology and Pharmaceutical Science 2 4%
Sports and Recreations 2 4%
Biochemistry, Genetics and Molecular Biology 2 4%
Other 7 13%
Unknown 17 30%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2020.
All research outputs
#15,866,607
of 23,577,654 outputs
Outputs from BMC Infectious Diseases
#4,573
of 7,855 outputs
Outputs of similar age
#211,506
of 330,426 outputs
Outputs of similar age from BMC Infectious Diseases
#74
of 142 outputs
Altmetric has tracked 23,577,654 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,855 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 330,426 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 142 others from the same source and published within six weeks on either side of this one. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.