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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-11-2021 | Wound Debridement | Orthopaedic Surgery

Surgical debridement of infected pubic symphysitis supports optimal outcome

Authors: Benjamin Devlieger, Daniel Wagner, Johannes Hopf, Pol Maria Rommens

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2021

Abstract

Introduction

Infected pubic symphysitis (IPS) is a rare bacterial infection of the pubic symphysis that causes subpubic pain, disability and ultimately permanent immobility. Due to difficult diagnosis, patients present with long-standing complaints and consult several doctors. To date, no validated treatment protocol exists and most patients are treated conservatively with antibiotics. This study was aimed to assess the results after careful surgical debridement and pathogen-specific antibiotic treatment in IPS.

Materials and methods

A chart review of eight patients with proven IPS was performed. Five of eight patients filled in a specific own-developed questionnaire and could be examined clinically and radiologically at a mean of 13 months (range: 6–30 months) postoperatively.

Results

There were six males and two females with an average age of 69 years (range: 55–80 years). The mean duration of symptoms before surgical treatment was 10.5 months (range: 1–30 months). There were no complications due to the surgical debridement. There was no recurrence of infection at the pubic symphysis during the follow-up period. The most common pathogen was Pseudomonas aeruginosa in three patients. Mean preoperative pain, measured on the visual analogue scale (VAS, range: 0–10) for the four analysed categories in the five follow-up patients was 7.2, 30 days postoperatively 2.7 and 13 months postoperatively 0.4. There was a steady increase in the quality of life (QoL) 30 days postoperatively and at the 13 months follow-up when compared to preoperative values.

Conclusions

Surgical debridement is the keystone for treatment of IPS and should be combined with local and systemic antibiotic therapy.

Available only for authorised users

Ethics commission of the state chamber of medicine of Rhineland-Palatinate (Ref. 837.140.17 (10,974)).

ICD (International statistical Classification of Diseases)—codes searched: S31.1, M13.15, M13.85, M25.55, M85.3, M86.25, M86.15, M86.05, M86,45, M86.55, M86.65, O26.719 and OPS (Operations and Procedure Code)-Code 5–800.3F.

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Title: Surgical debridement of infected pubic symphysitis supports optimal outcome
Authors: Benjamin Devlieger
Daniel Wagner
Johannes Hopf
Pol Maria Rommens
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Wound Debridement
Osteitis Pubis
Antibiotic
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2021
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03563-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical debridement of infected pubic symphysitis supports optimal outcome

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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