A Novel Irrigant to Eliminate Planktonic Bacteria and Eradicate Biofilm Superstructure With Persistent Effect During Total Hip Arthroplasty

Bashyal, Ravi K.; Mathew, Matt; Bowen, Edward; James, Garth A.; Stulberg, S. David

doi:10.1016/j.arth.2022.01.045

Cited by 9 publications

(10 citation statements)

References 37 publications

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“…It also exhibited increasing log reduction capability over time (5 minutes to 5 hours) against SSI/PJI causing bacteria established when present in a biofilm. 45 The novel irrigant exhibited equivalent, or better antimicrobial inhibitory and eradication activity against these and other microorganisms in planktonic or mature biofilm form when compared to betadine solution containing 10% w/v povidone iodine (PI). 46 Organizations such as the CDC and World Health Organization have addressed PI as an irrigant prior to wound closure.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the no-rinse feature facilitates residual XP in the incision space to continue its prophylactic activity for an extended period after closure. 45 In in vitro studies, XP exhibited 6 log or greater reduction in five minutes against planktonic forms of Pseudomonas aeruginosa and Staphylococcus aureus , known causative agents of SSI/PJI. It also exhibited increasing log reduction capability over time (5 minutes to 5 hours) against SSI/PJI causing bacteria established when present in a biofilm.…”

Section: Discussionmentioning

confidence: 99%

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Real-World Evidence of the Impact of a Novel Surgical Irrigant on Surgical Site Infections in Primary Total Knee Arthroplasty Performed at an Ambulatory Surgery Center

Singer

2024

Surgical Infections

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Background: Total knee arthroplasty (TKA) is one of the most common inpatient and outpatient surgical procedures performed in the United States and is predicted to increase 401% by 2040. Surgical site infections (SSIs) at an incidence rate of approximately 2% are costly post-operative complications in TKA. Intra-operative surgical irrigants are used to decrease contaminating microbial bioburden within the surgical site to prevent SSI. The primary objective of this retrospective study was to evaluate the impact of a novel surgical irrigant called XPERIENCE ® Advanced Surgical Irrigation (XP; Next Science, Jacksonville, FL) on SSI incidence in primary TKA performed at an ambulatory surgery center (ASC). Patients and Methods: Primary TKAs were performed at a free-standing ASC. The novel surgical irrigant was used intra-operatively to rinse away debris and micro-organisms from the surgical site. Retrospective data collation included SSI rates, complication rates, and re-admissions due to SSI within 90 days of index surgery. Results: Among the 524 primary TKA surgeries, one peri-prosthetic joint infection (PJI) was diagnosed within 90 days of index surgery and one superficial incisional SSI was diagnosed within 30 days of index surgery. The PJI was attributed to an exogenously acquired upper respiratory tract infection rather than due to the failure of intra-operative regimes. The 0.19% PJI incidence rate indicated significant efficacy of XP in decreasing PJI. An overall complication rate of 7.82% was noted with none of the complications associated with usage of the novel surgical irrigant. Conclusions: XPERIENCE is a promising intra-operative antimicrobial irrigant that can be easily incorporated into a broader infection prevention strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-World Evidence of the Impact of a Novel Surgical Irrigant on Surgical Site Infections in Primary Total Knee Arthroplasty Performed at an Ambulatory Surgery Center

Singer

2024

Surgical Infections

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“…30 , 31 In in vitro studies, XP exhibited antimicrobial activity against all bacteria evaluated, including planktonic and superstructure biofilms formed from microorganisms like Pseudomonas aeruginosa , Staphylococcus aureus and Cutibacterium acnes determined to be causative agents of PJIs/PSIs. 31 , 32 Additionally, XP exhibited equivalent, or better antimicrobial activity against microorganisms in comparison to Betadine solution (10% w/v Povidone Iodine [PI]). 31 , 32 Dilute PI has been evaluated for use by the CDC and World Health Organization as an intraoperative irrigant.…”

Section: Discussionmentioning

confidence: 99%

“… 31 , 32 Additionally, XP exhibited equivalent, or better antimicrobial activity against microorganisms in comparison to Betadine solution (10% w/v Povidone Iodine [PI]). 31 , 32 Dilute PI has been evaluated for use by the CDC and World Health Organization as an intraoperative irrigant. 33 , 34 In contrast to XP, dilute PI when used intraoperatively in joint replacement surgeries requires a soak time followed by an extensive rinse with saline solution.…”

Section: Discussionmentioning

confidence: 99%

“…The biocompatible and minimally cytotoxic nature of the product allows for the “no‐rinse” feature of XP, which lends to its ease of use during the surgical irrigation procedure and potentially enables residual XP in the surgical wound space to continue its prophylactic activity for an extended period after surgical incision closure 30,31 . In in vitro studies, XP exhibited antimicrobial activity against all bacteria evaluated, including planktonic and superstructure biofilms formed from microorganisms like Pseudomonas aeruginosa , Staphylococcus aureus and Cutibacterium acnes determined to be causative agents of PJIs/PSIs 31,32 . Additionally, XP exhibited equivalent, or better antimicrobial activity against microorganisms in comparison to Betadine solution (10% w/v Povidone Iodine [PI]) 31,32 .…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of a Novel Intraoperative Surgical Irrigant in Preventing Periprosthetic Joint Infections in Primary Knee, Hip, and Shoulder Arthroplasties: A Retrospective Analysis

Williams,

Harris

2024

Orthopaedic Surgery

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ObjectivePrimary joint arthroplasty (JA) is one of the most common operating room (OR) procedures, with knee and hip arthroplasties being listed in the top five most frequent OR procedures and while not as common, shoulder arthroplasties are increasing at greater rates than knee and hip arthroplasties. Periprosthetic joint/shoulder infections (PJI/PSI) are a devastating complication of primary JAs with infection prevention deemed as the single most important strategy in combating them. The objective of this study was to retrospectively evaluate the efficacy of XPERIENCE® Advanced Surgical Irrigation (XP) in preventing PJI following primary joint arthroplasty.MethodsThis is a retrospective study of primary knee, hip and shoulder arthroplasties that were performed by multiple orthopedic surgeons at a single hospital setting. XPERIENCE was used as an intraoperative surgical irrigant either solely, or with other intraoperative practices for prevention of infection. Incidence of acute PJI occurring within 90 days of index surgery were retrospectively collated.ResultsFour hundred and twenty‐three (423) primary joint replacement surgeries treated intraoperatively with XP, were evaluated for acute PJI incidence. Retrospective evaluations determined that 95% of the subjects had at least one risk factor predisposing them to PJI. There were zero PJIs diagnosed in the knee and hip arthroplasty cohorts and zero PSIs diagnosed in the shoulder arthroplasty cohorts.ConclusionThe absence of PJI/PSI diagnoses in the JA cohorts treated intraoperatively with XP indicates that it could be an efficacious antimicrobial irrigant in preventing PJI, and warrants being evaluated in prospective, randomized controlled clinical trials as the sole intraoperative irrigant, as well as in combination with the other intraoperative infection prevention regimens evaluated in this retrospective study.

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Advanced antibacterial effect of bioactive natural hydroxyapatite biocomposites

Özkaya,

Güler

2024

Studies in Natural Products Chemistry

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A Novel Irrigant to Eliminate Planktonic Bacteria and Eradicate Biofilm Superstructure With Persistent Effect During Total Hip Arthroplasty

Cited by 9 publications

References 37 publications

Real-World Evidence of the Impact of a Novel Surgical Irrigant on Surgical Site Infections in Primary Total Knee Arthroplasty Performed at an Ambulatory Surgery Center

Real-World Evidence of the Impact of a Novel Surgical Irrigant on Surgical Site Infections in Primary Total Knee Arthroplasty Performed at an Ambulatory Surgery Center

Efficacy of a Novel Intraoperative Surgical Irrigant in Preventing Periprosthetic Joint Infections in Primary Knee, Hip, and Shoulder Arthroplasties: A Retrospective Analysis

Advanced antibacterial effect of bioactive natural hydroxyapatite biocomposites

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