on the computed tomography (CT) images caused by the metal hardware. Often, there will be preoperative doubts whether the bone has united enough for stability to be kept after hard­ware removal. Even if imaging tests suggest con­solidation of three out of four cortices, sometimes intraoperative evaluation reveals instability after hardware removal and debridement. It is thus wise to have a plan in place for each scenario (bone stability versus instability after implant removal and debridement).

Debridement, antibiotics, and implant reten­tion (DAIR) approaches have lower success rates than implant exchange, but can achieve FRI reso­lution in >70% of well-selected patients [13, 16]. DAIR success depends strongly on the quality of the debridement and the presence of the above­mentioned optimal conditions for bone healing [1, 11]. Note that a healthy soft tissue envelope is indispensable for implant retention success, due to its contribution to both bone healing and ght­ing infection. Thus, in I3–4 cases, early (ideally simultaneous) ap coverage must be performed. The consequence of this is that if the intention is for the implant to be retained, it is wise to arrange for a surgeon capable of performing aps to be present in the surgery in anticipation of a ap being potentially needed, as opposed to involving said surgeon(s) postoperatively only once the team realizes that there is a post-debridement soft tissue defect to be managed, which inevitably delays coverage.