This article is more than 5 years old. Information may no longer be current.

Study: Perioperative techniques reduced surgical site infection rates following THA

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Reductions in total hip arthroplasty postoperative surgical site infection rates can be made through the use of several perioperative techniques, according to a recently presented study.

Jay R. Lieberman, MD, shared his findings at the Combined Open Meeting of the Hip Society and the American Association of Hip and Knee Surgeons, in San Francisco.

“There are a number of things we can do to try and reduce infections,” Lieberman said. “One is prophylactic antibiotics, another is skin preparations and then there is preoperative bacterial decolonization.”

Jay R. Lieberman

Standard protocols for antibiotic prophylaxis should include cefazolin, Lieberman noted, adding it should be administered less than 1 hour prior to the procedure. Patients who have an allergy can be given vancomycin or clindamycin, although if vancomycin is going to be used it should be started earlier.

Further, he noted, prophylactic antibiotics should be discontinued within 24 hours of the end of a procedure.

For skin preparation, Lieberman spoke on preoperative showers, hair removal and antiseptic techniques to sterilize skin. With regard to chlorhexidine gluconate (CHG) preoperative wash, he noted studies of mixed quality have found mixed results as to its efficacy — but it is an area for further study.

“This is an area of controversy in orthopedics because there is not a lot of data, particularly related to total joint replacement, and the clean nature of our cases makes infection rare,” Lieberman said. “There have been some recent clinical trials to assess [CHG’s] efficacy, but again, they are not in orthopedic surgery.”

Up to 30% of infections are caused by Staphylococcus aureus, Lieberman noted. Since it is a virulent pathogen, he noted, there has been interest in eliminating nasal carriage preoperatively.

“I think the decolonization is becoming more popular, but cost-benefit analysis studies need to be performed,” Lieberman said. “More studies need to be performed to determine the efficacy of CHG showers, and what we really need is an in-office test that is cheap to make this work more easily for us.”

Reference:

• Lieberman JR. Perioperative techniques to reduce postoperative infection. Presented at the Combined Open Meeting of the Hip Society and the American Association of Hip and Knee Surgeons. Feb. 11, 2012. San Francisco.
• Disclosure: Lieberman has no relevant financial disclosures.

Follow OrthoSuperSite.com on Twitter