Hydrogen peroxide to the dermis did not reduce incidence of infection during TSA
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TAMPA, Fla. — Application of hydrogen peroxide to the dermis did not significantly reduce the infection rate during shoulder arthroplasty, while standard skin preparation and antibiotic prophylaxis may be sufficient, results showed.
“[Cutibacterium acnes] C. acnes, as we all know, is the most common infection after shoulder arthroplasty,” Ryan Colley, DO, said in his presentation at the American Shoulder and Elbow Surgeons Annual Meeting, here.
In their level 1, prospective, randomized control trial, Colley and colleagues at Holy Cross Orthopedic Institute analyzed 30 patients who underwent primary total shoulder arthroplasty and received hydrogen peroxide to the dermis following incision. Researchers also analyzed an additional cohort of 30 patients who received standard skin preparation and antibiotic prophylaxis without an additional application of hydrogen peroxide.
According to the abstract, culture samples for C. acnes were taken from the skin, dermis, glenohumeral joint and air and were held for 14 days. Outcome measures included culture site, day of culture positivity and bacterial abundance of positive cultures.
After 14 days, Colley and colleagues found 20% of the hydrogen peroxide cohort and 16% of the control cohort had a positive culture for C. acnes. All positive cultures were C. acnes, Colley noted. No positive cultures were found in the glenohumeral joint. There were no wound complications. There were also no significant differences in culture site, day of culture positivity and bacterial abundance of positive cultures between the cohorts.
“We had a lower overall positive culture rate compared to prior studies,” Colley said. “This could be a result of our standard preoperative preparations or patient demographics,” he said.
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Colley R, et al. Paper 18. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Dec. 15-17, 2021; Tampa, Fla.
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