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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2011, Number 1

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Acta Ortop Mex 2011; 25 (1)

Infection prevention during the perioperative period of primary hip and knee arthroplasty

Suárez-Ahedo CE, Obil-Chavarría CA, Gil-Orbezo FI, García-Félix Díaz G

Language: Spanish
References: 89
Page: 4-11
PDF size: 454.52 Kb.


ABSTRACT

All surgical wounds are at risk of contamination by pathogens that may get in through the incision. The pre-surgical bath with a skin antiseptic agent 24 hours prior to the surgery, the timing of administration of prophylactic antibiotics, the choice and postoperative duration of the latter, the number of individuals within the OR and the movement inside it, the choice of chlorhexidine gluconate for its long duration against gram-positive and gram-negative organisms, and the use of a hair remover or an electric razor, all of the former concepts, some new and others not so new, led to performing an extensive bibliographic review with the idea of starting a standardization process that could change the way in which institutions operate when performing primary joint replacement, trying to reduce the annual infection rate and upgrade the quality of life of patients.


REFERENCES

  1. Prokuski L: Prophylactic antibiotics in orthopaedic surgery. J Am Acad Orthop Surg 2008; 16: 283-93.

  2. Bibbo C, Goldberg JW: Infectious and healing complications after elective orthopaedic foot and ankle surgery during tumor necrosis factor-alpha inhibition therapy. Foot Ankle Int 2004; 25: 331-5.

  3. Howe CR, Gardner GC, Kadel NJ: Perioperative medication management for the patient with rheumatoid arthritis. J Am Acad Orthop Surg 2006;14: 544-51.

  4. Sharma S, Nicol F, Hullin MG, McCreath SW: Long term results of the uncemented low contact stress total knee replacement in patients with rheumatoid arthritis. J Bone Joint Surg Br 2005; 87: 1077-80.

  5. Yang K, Yeo SJ, Lee BP, Lo NN: Total knee arthroplasty in diabetic patients: a study of 109 consecutive cases. J Arthroplasty 2001; 16: 102-6.

  6. Parvizi J, Sullivan TA, Pagnano MW, Trousdale RT, Bolander ME: Total joint arthroplasty in human immunodeficiency virus-positive patients: alarming rate of early failure. J Arthroplasty 2003; 18: 259-64.

  7. Bosco III JA, Slover JD, Haas JP: Perioperative strategies for decreasing infection: A comprehensive evidence-based approach. J Bone Joint Surg Am 2010; 92: 232-239.

  8. Furnary AP, Wu Y: Eliminating the diabetic disadvantage: the Portland Diabetic Project. Semin Thorac Cardiovasc Surg 2006; 18: 302-8.

  9. Furnary AP, Wu Y, Bookin SO: Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract 2004; 10 (Suppl 2): 21-33.

  10. Latham R, Lancaster AD, Covington JF, Pirolo JS, Thomas CS: The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 2001; 22: 607-12.

  11. Dreblow DM, Anderson CF, Moxness K: Nutritional assessment of orthopedic patients. Mayo Clin Proc 1981; 56: 51-4.

  12. Greene KA, Wilde AH, Stulberg BN: Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. J Arthroplasty 1991; 6: 321-5.

  13. Fairfield KM, Fletcher RH: Vitamins for chronic disease prevention in adults: scientific review. JAMA 2002; 288: 1720.

  14. Benowitz NL: Clinical pharmacology of nicotine. Annu Rev Med 1986; 37: 21-32.

  15. Heliövaara M, Karvonen MJ, Vilhunen R, Punsar S: Smoking, carbon monoxide and atherosclerotic disease. Br Med J 1978; 1: 268-70.

  16. Lindström D, Sadr Azodi O, Wladis A, Tønnesen H, Linder S, Nåsell H, Ponzer S, Adami J: Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg 2008; 248: 739-45

  17. Anaya DA, Dellinger EP: The obese surgical patient: a susceptible host for infection. Surg Infect 2006; 7: 473-80.

  18. Andreshak TG, An Hs, Hall J, Stein B: Lumbar spine surgery in the obese patient. J Spinal Disord 1997; 10: 376-9.

  19. Dowsey MM, Choong PF: Early outcomes and complications following joint arthroplasty in obese patients: a review of the published reports. ANZ J Surg 2008; 78: 439-44.

  20. Maderazo EG, Judson S, Pasternak H: Late infections of total joint prostheses. A review and recommendations for prevention. Clin Orthop Relat Res 1988; 229: 131-42.

  21. Cuenca J, García-Erce JA, Martínez AA, Solano VM, Molina J, Muñoz M: Role of parenteral iron in the management of anaemia in the elderly patient undergoing displaced subcapital hip fracture repair: preliminary data. Arch Orthop Trauma Surg 2005; 125: 342-7.

  22. Auerbach M, Goodnough LT, Picard D, Maniatis A: The role of intravenous iron in anemia management and transfusion avoidance. Transfusion 2008; 48: 988-1000.

  23. Veiga DF, Damasceno CA, Veiga-Filho J, Figueiras RG, Vieira RB, Garcia ES, Silva VV, Novo NF, Ferreira LM: Randomized controlled trial of the effectiveness of chlorhexidine showers before elective plastic surgical procedures. Infect Control Hosp Epidemiol 2009; 30: 77-9.

  24. Hanssen AD, Osmon DR: The use of prophylactic antimicrobial agents during and after hip arthroplasty. Clin Orthop Relat Res 1999; 369: 124-38.

  25. Burke JP: Maximizing appropriate antibiotic prophylaxis for surgical patients: an update from LDS Hospital, Salt Lake City. Clin Infect Dis 2001; 33 (Suppl 2): S78-83.

  26. Burke JF: The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery 1961; 50: 161-8.

  27. Fukatsu K, Saito H, Matsuda T, Ikeda S, Furukawa S, Muto T: Influences of type and duration of antimicrobial prophylaxis on an outbreak of methicillin-resistant Staphylococcus aureus and on the incidence of wound infection. Arch Surg 1997; 132: 1320-5.

  28. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP: The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992; 326: 281-6.

  29. Bannister GC, Auchincloss JM, Johnson DP, Newman JH: The timing of tourniquet application in relation to prophylactic antibiotic administration. J Bone Joint Surg Br 1988; 70: 322-4.

  30. Southorn PA, Plevak DJ, Wright AJ, Wilson WR: Adverse effects of vancomycin administered in the perioperative period. Mayo Clin Proc 1986; 61: 721-4.

  31. Renz CL, Thurn JD, Finn HA, Lynch JP, Moss J: Antihistamine prophylaxis permits rapid vancomycin infusion. Crit Care Med 1999; 27: 1732-7.

  32. Clyburn TA: Timing of prophylactic antibiotics in TJA. AAOS Bulletin 2005; 53: 13,17.

  33. Dehne MG, Mühling J, Sablotzki A, Nopens H, Hempelmann G: Pharmacokinetics of antibiotic prophylaxis in major orthopedic surgery and blood-saving techniques. Orthopedics 2001; 24: 665-9.

  34. Auerbach AD: Prevention of surgical site infections. In: Shojania KG, Duncan BW, McDonald KM, Wachter RM, editors. Making health care safer: a critical analysis of patient safety practices. Evidence report/technology assessment no. 43. AHRQ publication no. 01-E058. Rockville, MD: Agency for Healthcare Research and Quality; http://www.ahrq.gov/clinic/ptsafety/pdf/ptsafety.pdf. Accessed. 2007-05-15.

  35. American Academy of Orthopaedic Surgeons. Advisory statement. Recommendations for the use of intravenous antibiotic prophylaxis in primary total joint arthroplasty. http://www.aaos.org/about/papers/advistmt/1027.asp. Accessed. 2007-05-15.

  36. Slobogean GP, Kennedy SA, Davidson D, O’Brien PJ: Single-versus multiple-dose antibiotic prophylaxis in the surgical treatment of closed fractures: a meta-analysis. J Orthop Trauma 2008; 22: 264-9.

  37. Charnley J: Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop Relat Res 1972; 87: 167-87.

  38. Periti P, Mini E, Mosconi G: Antimicrobial prophylaxis in orthopaedic surgery: the role of teicoplanin. J Antimicrob Chemother 1998; 41: 329-40.

  39. Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH: Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg 1993; 128: 79-88.

  40. Mauerhan DR, Nelson CL, Smith DL, Fitzgerald RH Jr, Slama TG, Petty RW, Jones RE, Evans RP: Prophylaxis against infection in total joint arthroplasty. One day of cefuroxime compared with three days of cefazolin. J Bone Joint Surg Am 1994; 76: 39-45.

  41. Patzakis MJ, Wilkins J, Kumar J, Holtom P, Greenbaum B, Ressler R: Comparison of the results of bacterial cultures from multiple sites in chronic osteomyelitis of long bones. A prospective study. J Bone Joint Surg Am 1994; 76: 664-6.

  42. Fitzgerald RH, Jr: Infected total hip arthroplasty: diagnosis and treatment. J Am Acad Orthop Surg 1995; 3: 249-62.

  43. Gruchalla RS, Pirmohamed M: Clinical practice. Antibiotic allergy. N Engl J Med 2006; 354: 601-9.

  44. Kelkar PS, Li JT: Cephalosporin allergy. N Engl J Med 2001; 345: 804-9.

  45. Fridkin SK, Edwards JR, Courval JM, Hill H, Tenover FC, Lawton R, Gaynes RP, McGowan JE, Jr: Intensive care antimicrobial resistance epidemiology (ICARE) project and the national nosocomial infections surveillance (NNIS) system hospitals. The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 2001; 135: 175-83.

  46. Fridkin SK, Lawton R, Edwards JR, Tenover FC, McGowan JE Jr, Gaynes RP: Intensive care antimicrobial resistance epidemiology project; national nosocomial infections surveillance systems hospitals. Monitoring antimicrobial use and resistance: comparison with a national benchmark on reducing vancomycin use and vancomycin-resistant enterococci. Emerg Infect Dis 2002; 8: 702-7.

  47. Neu HC: Cephalosporin antibiotics as applied in surgery of bones and joints. Clin Orthop Relat Res 1984; 190: 50-64.

  48. Darley ES, MacGowan AP: Antibiotic treatment of gram-positive bone and joint infections. J Antimicrob Chemother 2004; 53: 928-35.

  49. Dellinger EP, Gross PA, Barrett TL, Krause PJ, Martone WJ, McGowan JE Jr, Sweet RL, Wenzel RP: Quality standard for antimicrobial prophylaxis in surgical procedures. Infectious Diseases Society of America. Clin Infect Dis 1994; 18: 422-7.

  50. Li JT, Markus PJ, Osmon DR, Estes L, Gosselin VA, Hanssen AD: Reduction of vancomycin use in orthopedic patients with a history of antibiotic allergy. Mayo Clin Proc 2000; 75: 902-6.

  51. Oishi CS, Carrion WV, Hoaglund FT: Use of prophylactic antibiotics in clean orthopedic surgery. A review of the literature. Clin Orthop Relat Res 1993; 269: 249-55.

  52. Bratzler DW, Houck PM: Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004; 38: 1706-15.

  53. Strausbaugh LJ, Crossley KB, Nurse BA, Thrupp LD: Antimicrobial resistance in long term-care facilities. Infect Control Hosp Epidemiol 1996; 17: 129-40.

  54. Drinkwater CJ, Neil MJ: Optimal timing of wound drain removal following total joint arthroplasty. Arthroplasty 1995; 10: 185-9.

  55. Beer KJ, Lombardi AV Jr, Mallory Th, Vaughn BK: The efficacy of suction drains after routine total joint arthroplasty. J Bone Joint Surg Am 1991; 73: 7-91.

  56. Parker MJ, Roberts CP, Hay D: Closed suction drainage for hip and knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 2004; 86: 1146-52.

  57. Sankar B, Ray P, Rai J: Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations. Int Orthop 2004; 28: 311-4.

  58. Manian FA, Meyer PL, Setzer J, Senkel D: Surgical site infections associated with methicillin-resistant Staphylococcus aureus: do postoperative factors play a role? Clin Infect Dis 2003; 36: 863-8.

  59. Weber EW, Slappendel R, Prins MH, van der Schaaf DB, Durieux ME, Strumper D: Perioperative blood transfusions and delayed wound-healing after hip replacement surgery: effects on duration of hospitalization. Anesth Analg 2005; 101: 1416-21.

  60. Jaffray DC, Nade S: Does surgical glove powder decrease the inoculum of bacteria required to produce an abscess? J R Coll Surg Edinb 1983; 28: 219-22.

  61. Allo MD, Tedesco M: Operating room management: operative suite considerations, infection control. Surg Clin North Am 2005; 85: 1291-7.

  62. Albrich WC, Harbarth S: Health-care workers: source, vector, or victim of MRSA? Lancet Infect Dis 2008; 8: 289-301.

  63. Babkin Y, Raveh D, Lifschitz M, Itzchaki M, Wiener-Well Y, Kopuit P, Jerassy Z, Yinnon AM: Incidence and risk factors for surgical infection after total knee replacement. Scand J Infect Dis 2007; 39: 890-5.

  64. Ostrander RV, Botte MJ, Brage ME: Efficacy of surgical preparation solutions in foot and ankle surgery. J Bone Joint Surg Am 2005; 87: 980-5.

  65. Jacobson C, Osmon DR, Hanssen A, Trousdale RT, Pagnano MW, Pyrek J, Berbari E, Naessens J: Prevention of wound contamination using DuraPrep solution plus Ioban 2 drapes. Clin Orthop Relat Res 2005; 439: 32-7.

  66. Gross A, Cutright DE, Bhaskar SN: Effectiveness of pulsating water jet lavage in treatment of contaminated crushed wounds. Am J Surg 1972; 124: 373-7.

  67. Brown LL, Shelton HT, Bornside GH, Cohn I Jr: Evaluation of wound irrigation by pulsatile jet and conventional methods. Ann Surg 1978; 187: 170-3.

  68. Moussa FW, Gainor BJ, Anglen JO, Christensen G, Simpson WA: Disinfecting agents for removing adherent bacteria from orthopaedic hardware. Clin Orthop Relat Res 1996; 329: 255-62.

  69. Kalteis T, Lehn N, Schroder HJ, Schubert T, Zysk S, Handel M, Grifka J: Contaminant seeding in bone by different irrigation methods: an experimental study. J Orthop Trauma 2005; 19: 591-6.

  70. Bhandari M, Adili A, Lachowski RJ: High pressure pulsatile lavage of contaminated human tibia: an in vitro study. J Orthop Trauma 1998; 12: 479-84.

  71. Furukawa K, Tajiri T, Sudzuki H, Norose Y: Are sterile water and brushes necessary for hand washing before surgery in Japan? J Nippon Med Sch 2005; 72: 149-54.

  72. Wheelock SM, Lookinland S: Effect of surgical hand scrub time on subsequent bacterial growth. AORN J 1997; 65: 1087-92, 1094-8.

  73. Ayliffe GA: Surgical scrub and skin disinfection. Infect Control 1984; 5: 23-7.

  74. Dahl J, Wheeler B, Mukherjee D: Effect of chlorhexidine scrub on postoperative bacterial counts. Am J Surg 1990; 159: 486-8.

  75. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR: Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20: 250-80.

  76. Cho CY, Lo JS. Dressing the part. Dermatol Clin 1998; 16: 25-47.

  77. Mertz PM, Marshall DA, Eaglstein WH: Occlusive wound dressings to prevent bacterial invasion and wound infection. J Am Acad Dermatol 1985; 12: 662-8.

  78. Holm C, Petersen JS, Gronboek F, Gottrup F: Effects of occlusive and conventional gauze dressings on incisional healing after abdominal operations. Eur J Surg 1998; 164: 179-83.

  79. Eaglstein WH: Experiences with biosynthetic dressings. J Am Acad Dermatol 1985; 12: 434-40.

  80. Bolton LL, Johnson CL, Van Rijswijk L: Occlusive dressings: therapeutic agents and effects on drug delivery. Clin Dermatol 1991; 9: 573-83.

  81. Hutchinson JJ, McGuckin M: Occlusive dressings: A microbiologic and clinical review. Am J Infect Control 1990; 18: 257-68.

  82. Chrintz H, Vibits H, Cordtz TO, Harreby JS, Waaddegaard P, Larsen SO. Need for surgical wound dressing. Br J Surg 1989; 76: 204-5.

  83. Meylan G, Tschantz P: [Surgical wounds with or without dressings. Prospective comparative study]. Ann Chir 2001; 126: 459-62. French.

  84. Geronemus RG, Mertz PM, Eaglstein WH: Wound healing. The effects of topical antimicrobial agents. Arch Dermatol 1979; 115: 1311-4.

  85. Dire DJ, Coppola M, Dwyer DA, Lorette JJ, Karr JL: Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED. Acad Emerg Med 1995; 2: 4-10.

  86. Cruse PJ, Foord R: The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980; 60: 27-40.

  87. Tanner J, Woodings D, Moncaster K: Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev 2006; 3: 904.

  88. Seropian R, Reynolds BM: Wound infections after preoperative depilatory versus razor preparation. Am J Surg 1971; 121: 251-4.

  89. Bratzler DW, Hunt DR: The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006; 43: 322-30.




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