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Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements
BACKGROUND AND PURPOSE: Previous work has shown that despite preventive measures, intraoperative contamination of joint replacements is still common, although most of these patients seem to do well in follow-up of up to 5 years. We analyzed the prevalence and bacteriology of intraoperative contamina...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Informa Healthcare
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967258/ https://www.ncbi.nlm.nih.gov/pubmed/24650025 http://dx.doi.org/10.3109/17453674.2014.899848 |
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author | Jonsson, Eythor Örn Johannesdottir, Hera Robertsson, Otto Mogensen, Brynjolfur |
author_facet | Jonsson, Eythor Örn Johannesdottir, Hera Robertsson, Otto Mogensen, Brynjolfur |
author_sort | Jonsson, Eythor Örn |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Previous work has shown that despite preventive measures, intraoperative contamination of joint replacements is still common, although most of these patients seem to do well in follow-up of up to 5 years. We analyzed the prevalence and bacteriology of intraoperative contamination of primary joint replacement and assessed whether its presence is related to periprosthetic joint infection (PJI) on long-term follow-up. PATIENTS AND METHODS: 49 primary total hip replacements (THRs) and 41 total knee replacements (TKRs) performed between 1990 and 1991 were included in the study. 4 bacterial swabs were collected intraoperatively during each procedure. Patients were followed up for joint-related complications until March 2011. RESULTS: 19 of 49 THRs and 22 of 41 TKRs had at least 1 positive culture. Coagulase-negative staphylococci and Staphylococcus aureus were the most common organisms, contaminating 28 and 9 operations respectively. Where information was available, bacteria from 27 of 29 contaminated operations were susceptible to the prophylactic antibiotic administered. 13% of samples gathered before 130 min of surgery were contaminated, as compared to 35% collected after that time. 2 infections were diagnosed, both in TKRs. 1 of them may have been related to intraoperative contamination. INTERPRETATION: Intraoperative contamination was common but few infections occurred, possibly due to the effect of prophylactic antibiotics. The rate of contamination was higher with longer duration of surgery. It appears that positive results from intraoperative swabs do not predict the occurrence of PJI. |
format | Online Article Text |
id | pubmed-3967258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Informa Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-39672582014-04-03 Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements Jonsson, Eythor Örn Johannesdottir, Hera Robertsson, Otto Mogensen, Brynjolfur Acta Orthop Hip and Knee BACKGROUND AND PURPOSE: Previous work has shown that despite preventive measures, intraoperative contamination of joint replacements is still common, although most of these patients seem to do well in follow-up of up to 5 years. We analyzed the prevalence and bacteriology of intraoperative contamination of primary joint replacement and assessed whether its presence is related to periprosthetic joint infection (PJI) on long-term follow-up. PATIENTS AND METHODS: 49 primary total hip replacements (THRs) and 41 total knee replacements (TKRs) performed between 1990 and 1991 were included in the study. 4 bacterial swabs were collected intraoperatively during each procedure. Patients were followed up for joint-related complications until March 2011. RESULTS: 19 of 49 THRs and 22 of 41 TKRs had at least 1 positive culture. Coagulase-negative staphylococci and Staphylococcus aureus were the most common organisms, contaminating 28 and 9 operations respectively. Where information was available, bacteria from 27 of 29 contaminated operations were susceptible to the prophylactic antibiotic administered. 13% of samples gathered before 130 min of surgery were contaminated, as compared to 35% collected after that time. 2 infections were diagnosed, both in TKRs. 1 of them may have been related to intraoperative contamination. INTERPRETATION: Intraoperative contamination was common but few infections occurred, possibly due to the effect of prophylactic antibiotics. The rate of contamination was higher with longer duration of surgery. It appears that positive results from intraoperative swabs do not predict the occurrence of PJI. Informa Healthcare 2014-04 2014-03-20 /pmc/articles/PMC3967258/ /pubmed/24650025 http://dx.doi.org/10.3109/17453674.2014.899848 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. |
spellingShingle | Hip and Knee Jonsson, Eythor Örn Johannesdottir, Hera Robertsson, Otto Mogensen, Brynjolfur Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title | Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title_full | Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title_fullStr | Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title_full_unstemmed | Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title_short | Bacterial contamination of the wound during primary total hip and knee replacement: Median 13 years of follow-up of 90 replacements |
title_sort | bacterial contamination of the wound during primary total hip and knee replacement: median 13 years of follow-up of 90 replacements |
topic | Hip and Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967258/ https://www.ncbi.nlm.nih.gov/pubmed/24650025 http://dx.doi.org/10.3109/17453674.2014.899848 |
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