[HSF] PVE

[Nasser F. Abou'Seada]

Hal
that is a very bold opinion !
like you I would certainly (hope) the re-infection rate is non. however I
would hope for favourable odds counting on the interplay of many variables
as to the offending organism's virulence, invasiveness, inoculum
size (especially in such a case), positive gram stain, status of
immunity, local tissue status as a fuction of technique ..etc

to my mind, the technique is a very important variable, I'd figure
that having no new RAW area of the adjacent annulus exposed, but rather
the healed old annulus treated with antibiotics, betadine paint, would
rather tremendously reduce the size of any offending inoculum, especially if
combined with a minimal touch of a forceps. but these are all hopes and
speculations. the real balance will take place in the patient's milieu.

Incidentally, you mean Carpentier would not change instruments taking out an
infected prosthesis ? or have I got that wrongly ?

NFA

On 5/5/07, Hgrmd at aol.com <Hgrmd at aol.com> wrote:
>
> Ed,
> I don't think changing instruments after debriding infected tissue  is
> that
> important.  Like you, I generally do it, simply because that's the  way
> I've
> seen Carpentier do it.  However, for years I didn't do it, and I  really
> don't
> think the reinfection was high then or now.
> Hal
>
>
>
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-- 
Nasser  F.  Abou'Seada,
MB,ChB,MD,FRCSEd,ChM,ChD C/Th,
FICS,FISCVS,FSSRCTS,FHMS,MESC