Multidisciplinary Team
In the absence of reliable evidence, it is the opinion of the work group that patients with surgical site infections are optimally managed by a multidisciplinary team with expertise in the management of musculoskeletal infections. In addition to individual patient care management, multidisciplinary orthopaedic infection teams may strive to improve diagnostic capabilities, streamline care, create and maintain care pathways, coordinate discharge planning efforts, facilitate quality improvement efforts and improve patient education.

Rationale

The composition of a multidisciplinary team will depend upon local resources; optimally the team should include orthopaedic surgeons and infectious disease experts. Others whose input would be valuable in some settings: include plastic surgeons and other wound care experts, pharmacists, nursing personnel, pathologists, microbiologists, radiologists, discharge planners, and home health providers. Infectious disease experts aid in the interpretation of diagnostic tests, selection of optimal antimicrobials based on microbial and host factors, and facilitation of safe antimicrobial administration oversight. Surgeons with soft tissue coverage expertise may be helpful. Physical therapists provide modalities to mitigate lost range of motion in associated joints, degreased muscle strength, general deconditioning and to control edema. Hospitalist medicine specialists and primary care providers are often necessary for optimization of patients’ overall health. Laboratory personnel can assure proper acquisition, handling, and testing of specimens. Early planning for discharge is coordinated by discharge planning staff, pharmacy technicians, and home health care services.