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Perioperative protocols could decrease surgical-site infection after TJA
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Among patients undergoing total joint arthroplasty, the addition of a perioperative protocol could further decrease surgical site infections, according to study results.
Researchers devised a detailed arthroplasty protocol to lower infection rates among patients undergoing total joint arthroplasty (TJA). The researchers included 178 patients, of whom 70 underwent surgery prior to 2004 (pre-protocol group/control group) and 108 underwent surgery after 2004 (post-protocol group/test group). Variables recorded included age, gender, indication for surgery, comorbidities, smoking status, HIV status, insurance status, nasal swab data (if performed), complications, length of stay, time to diagnosis of infection and need for reoperation.
Study results showed a 12.9% infection rate in the pre-protocol group vs. a 1.9% infection rate in the post-protocol group, indicating a statistically significant between-group difference, according to the researchers.
The post-protocol group had an 87% lower risk of any infection compared with the pre-protocol group. Additionally, this risk was 77% lower when the operation involved the hip vs. the knee.
The researchers found implant costs to the hospital of $5,600 for total hip arthroplasty (THA) and $4,800 for total knee arthroplasty (TKA), with an additional cost of $800 if cement was used, as well as $300 for each packet of vancomycin impregnated cement and $500 for each packet of tobramycin-impregnated cement.
When the difference in cost for all infections from each group was divided by the difference in non-infected number of patients, the researchers calculated a total of $14,942.80 that could be spent on each subsequent patients to prevent infection and still break even.
Disclosure: The authors have no relevant financial disclosures.
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