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Wound vacuum-assisted closure dressing
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IV antibiotics for 6 weeks flowed by long term oral antibiotics
Irrigation and debridement and polyethylene exchange
Two-stage debridement and reconstruction
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This situation represents a definitively and chronically infected knee replacement. Antibiotic therapy alone may suppress the infection but will not eradicate it. Debridement and polyethylene exchange would be appropriate treatment for an early postoperative infection. The treatment of choice is to perform a 2-stage debridement and reconstruction. Although not among the listed choices, an aspiration or culture can be done presurgically and may help clinicians identify the best antibiotics to treat the condition. Antibiotic selection would not affect the need for the 2-stage reconstruction, however.
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