Contamination Rate of Burnt Necrotic Tissue after Electrocoagulation in Total Knee Arthroplasty

Rattanaprichavej, Piti; Laoruengthana, Artit; Galassi, Monton; Weerakul, Santi; Rasamimongkol, Supachok

doi:10.4055/cios.2020.12.1.43

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Periprosthetic joint infections (PJIs) are one of the most serious complications after total knee arthroplasty (TKA) [ 1 – 4 ] ) . In the early stage of a PJI, debridement, antibiotics, and implant retention (DAIR) may be useful surgical options [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Worse outcome of debridement, antibiotics, and implant retention in acute hematogenous infections than in postsurgical infections after total knee arthroplasty: a multicenter study

Chang

Kim

et al. 2022

Knee Surg & Relat Res

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Background We sought to determine (1) the success rate of debridement, antibiotics, and implant retention (DAIR) for acute periprosthetic joint infection (PJI) of the knee in patients with acute postsurgical infection and in those with acute hematogenous infection via a multicenter study, (2) the factors related to the failure of DAIR for overall acute PJI and acute hematogenous PJI via subgroup analysis, and (3) whether the PJI recurrence patterns differed between the two groups over time after DAIR. Methods This retrospective multicenter study included 101 acute knee PJI. Acute postsurgical PJI was defined as PJI diagnosed < 3 months following initial knee arthroplasty surgery. DAIR was performed for 34 cases of acute postsurgical PJIs (postsurgical group) and 67 cases of acute hematogenous PJIs (hematogenous group). The success rates between groups were compared, and factors related to DAIR failure were analyzed. Results The overall success rate of DAIR was 77%. The success rate tended to be higher in the postsurgical group than in the hematogenous group (p = 0.060). However, there was no significant factor related to DAIR failure in the subgroup analysis of acute hematogenous PJIs. In the postsurgical group, the recurrence of PJI occurred until 3 months, whereas in the hematogenous group, recurrence occurred for up to 2 years. Conclusions The failure rate tended to be higher in the acute hematogenous PJI group than in the acute postsurgical PJI group. Since acute hematogenous infections may recur for a longer period than postsurgical infections, careful follow-up is required after DAIR.

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Section: Introductionmentioning

confidence: 99%

Worse outcome of debridement, antibiotics, and implant retention in acute hematogenous infections than in postsurgical infections after total knee arthroplasty: a multicenter study

Chang

Kim

et al. 2022

Knee Surg & Relat Res

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“…Infection after primary total knee arthroplasty (TKA) occurs approximately in 1% of all cases and may cause critical complications. [ 1 , 2 ] Surgeons put a lot of effort to prevent some of the complications by using prophylactic antibiotics or reducing postoperative transfusion. Nowadays, although there is no doubt on using prophylactic antibiotics, [ 3 ] there are no “totally-agreed” guidelines on the duration of antibiotic use.…”

Section: Introductionmentioning

confidence: 99%

“…Infection after primary total knee arthroplasty (TKA) occurs approximately in 1% of all cases and may cause critical complications [1,2] . Surgeons put a lot of effort to prevent some of the complications by using prophylactic antibiotics or reducing postoperative transfusion.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty

Jang

Choi

2022

Medicine

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We researched on the factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty (TKA). Four hundred and eighty-nine cases who underwent primary TKA performed by 1 surgeon from January 2015 to December 2018 were enrolled. Including the day of operation, first-generation cephalosporin was injected intravenously for 3 days for antimicrobial prophylaxis. At the third postoperative day, we inspected the surgical wound for any signs of inflammation. If there were any signs of redness, pain, heatness, or swelling, which are the cardinal signs of superficial incisional surgical site infection defined by the Centers of Disease Control (CDC), additional antibiotics were injected until the symptoms of surgical site inflammation improved. We presumed that the duration of antibiotic use was affected by factors including gender, age, body mass index, whether operating on both legs or one leg, predisposing diabetes mellitus, preoperative glomerular filtration rate, preoperative serum albumin level, prior history of anticoagulant usage including anti-platelet agents, allogenic blood transfusion during admission, and total operative time. Average duration of intravenous antibiotic use in 489 cases was 5.73 ± 4.03 days. Pearson correlation analysis showed significant correlation ( P < .01) between operative time and duration of antibiotic use due to surgical site inflammation. In univariate analysis, total operative time and transfusion were factors affecting the duration of antibiotic use due to surgical site inflammation (<6 days or ≥6 days). Multivariate analysis of age, gender, body mass index, staged bilateral TKA, diabetes mellitus, preoperative glomerulus filtration rate, preoperative albumin level, prior history of anticoagulant usage, allogenic blood transfusion during admission, and total operative time revealed that longer operative time was related to higher likelihood of antibiotic use for >6 days during admission. When prophylactic antibiotics are prescribed, surgeons must note that signs of superficial incisional surgical site inflammation after classical complication free TKA may manifest more often in patients with longer operative time.

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A Prospective Randomized Controlled Study of Stratafix versus Standard-of-Care for Deep Tissue Closure in Orthopedic Surgery

Song,

Cho

2024

Clin Orthop Surg

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Background Orthopedic deep surgical incisions require the approximation of 1 or multiple tissue layers. This prospective randomized controlled study aimed to assess the usefulness and effectiveness of a barbed suture technique (Stratafix symmetric PDS plus) versus the conventional interrupted knotted suture technique for deep tissue closure in orthopedic surgery by comparing deep fascia suture time, relative cost, and wound-related complications. Methods A total of 254 patients with deep surgical incisions who underwent orthopedic surgery between October 1, 2020, and June 30, 2021, were recruited. Their general characteristics (age, sex, weight, height, body mass index, American Society of Anesthesiologists physical status score, total operation time, and length of deep incision) and factors related to deep incision wounds (suture type and number, wound closure time, and operation site outcomes) were collected. Results The general characteristics did not differ between the Stratafix and conventional groups. There were no between-group differences observed in total operation time or total anesthesia time. The wound suture times differed significantly. In the conventional group, the suture time per unit length was lower in the group with the length of deep incision under 20 cm but did not differ significantly for each wound size. In the Stratafix group, the suture time per unit length was lower in the group under 15 cm, with the shortest time observed for 10–14.9 cm, followed by 5.0–9.9 cm and the group under 5 cm. The conventional group developed 4 cases of superficial wound infection or surgical wound necrosis. One case of protruded suture tap occurred in the Stratafix group. Conclusions The average suture time per unit length increased for lengths under 5 cm as barbed sutures required more time from the start of the first suture to finish of the last suture. There was no significant benefit for very short suture length. One barbed suture material allows a suture of approximately 10–12 cm; sutures beyond that require more time because the surgeon has to start again. The Stratafix group used less suture material than the conventional group.

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Contamination Rate of Burnt Necrotic Tissue after Electrocoagulation in Total Knee Arthroplasty

Cited by 3 publications

References 30 publications

Worse outcome of debridement, antibiotics, and implant retention in acute hematogenous infections than in postsurgical infections after total knee arthroplasty: a multicenter study

Worse outcome of debridement, antibiotics, and implant retention in acute hematogenous infections than in postsurgical infections after total knee arthroplasty: a multicenter study

Factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty

A Prospective Randomized Controlled Study of Stratafix versus Standard-of-Care for Deep Tissue Closure in Orthopedic Surgery

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