Infection After Fracture: Viewpoints & Watchpoints for Orthopedic Surgeons, Trauma Surgeons & PG Trainees | PICASSO Protocol and OrthoPlastic MIDASS Concept for Fracture-Related Infection

Infection After Fracture: Viewpoints & Watchpoints is a practical, first-principles guide to one of orthopedic trauma's most difficult and stubborn problems - infection following fracture fixation. Rather than offering rigid protocols or leaning on excessive antibiotic use, the book is built around meticulous debridement, soft-tissue management, mechanical stability, and multidisciplinary collaboration, drawn from extensive clinical experience within the complex realities of Indian trauma practice. The well-established orthoplastic approach is expanded into the OrthoPlastic MIDASS concept for contaminated and infected fractures, and the PICASSO protocol is introduced to streamline assessment and management decisions. Across 21 chapters, coverage spans epidemiology, microbiology, antimicrobial stewardship, surgical site infection prevention, debridement and skeletal stabilization in open fractures, soft-tissue cover, implant retention-versus-removal decisions, infected nonunion, infection in an already-united fracture, host health status, and the role of the multidisciplinary team - presented through real clinical case reports with structured Assessment-Objectives-Strategy decision frameworks, boxed quick-reference summaries, diagrammatic debridement schematics, and extensive serial clinical photographs and radiographs. Who This Book Is For: Orthopedic and trauma surgeons: managing open or infected fractures who need a standalone, practical reference for a problem that is rarely taught systematically. Orthopedic postgraduates (MS/DNB): building a structured approach to fracture-related infection. Orthopedic residents and fellowship trainees: rotating through trauma and reconstruction services who need to learn real case-based decision-making, not just theory. Why This Book Helps: Resolves the hardest surgical dilemma directly: whether to retain or remove an implant in early infection, through a structured DAIR-based decision framework rather than vague general advice. Teaches through real cases, not just theory: de-identified case reports walk through Assessment, Objectives, and Strategy for each scenario, with concrete outcomes. Curbs indiscriminate antibiotic use: the ABC of Antimicrobials chapter and culture-directed case examples model responsible antimicrobial stewardship. Works across resource settings: guidance is built for both resource-poor and resource-rich establishments, reflecting the realities of Indian trauma units. Key Features: Introduces the PICASSO protocol, a streamlined framework for assessing and managing infected/contaminated fractures Expands the established orthoplastic approach into the OrthoPlastic MIDASS concept 21 chapters spanning epidemiology, microbiology, antimicrobials, prevention, debridement, soft-tissue cover, skeletal stabilization, infected nonunion, and host-factor optimization Real clinical case reports with structured Assessment-Objectives-Strategy frameworks, Learning Points takeaway boxes, and culture-directed antibiotic regimens Extensive clinical photographs, serial radiographs, and original diagrammatic schematics illustrating debridement technique

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