General Assembly, Prevention, Surgical Site Preparation: Proceedings of International Consensus on Orthopedic Infections

Evaluation of Incise Drape Lift Using 2% Chlorhexidine Gluconate/70% Isopropyl Alcohol Preoperative Skin Preparations in a Human Volunteer Knee Model

“…Adhesive incise drapes were introduced in the 1960s [ 3 ] with the intent of preventing the contamination of the incised tissues with bacteria from the surrounding skin and therefore help reduce the wound infection rate [ 4 , 5 ]. The use of adhesive drapes is considered an option to immobilize the resident bacterial skin flora that persists after the application of antimicrobial skin preparations: Theoretically, the drape prevents lateral migration and proliferation of bacteria [ 6 ].…”

“…These properties offer the potential to reduce the rate of SSIs [ 11 ]. However, the benefits of incise drapes have been debated, with conflicting results published on their efficacy [ 7 , 10 , [12] , [13] , [14] , [15] ], as well as conflicting recommendations regarding their use [ 5 , [16] , [17] , [18] ]. A Cochrane review on this topic concluded that standard plastic adhesive drapes led to more SSIs than no drape and that iodine-impregnated adhesive drapes had no effect on the SSI rate [ 19 ].…”

“…However, another recent study demonstrated than an iodophor-impregnated adhesive drape significantly reduced bacterial colonization of the incision in 101 patients undergoing open joint preservation procedures of the hip (6 incisions with drapes, or 12%, vs 14 incisions without drapes, or 27.5%, were positive for bacteria) [ 9 ]. An international consensus document on preventing orthopedic infections reports that there is evidence for antimicrobial-impregnated incise drapes resulting in a reduction in bacterial colonization of the surgical site (level of evidence: limited) [ 5 ]. A significant association has been demonstrated between intraoperative bacterial surgical wound contamination and the risk of postoperative SSI [ 20 , 21 ].…”

Infección asociada a implantes ortopédicos. Serie de casos

“…En 2012, -tra efectos inhibitorios a la adhesión bacteriana, uniéndose a las células bacterianas la mayor incidencia de infecciones en los pacientes malnutridos. 14 En el consenso intravenoso por un período corto de tiempo -cefalosporinas de primera generación, (clindamicina o vancomicina en pacientes alérgicos) -, se mantiene como una de las piedras angulares en la reducción de la incidencia de infección asociada a dispositivos ortopédicos, 10 en nuestra serie se adminis-mento adecuado en todos los pacientes.…”

Preoperative Optimization and Tips to Avoiding Surgical Complications Before the Incision

“…Preoperative skin cleansing at home is commonly used in elective joint arthroplasty surgery and has been found to have a role in decreasing SSI as well as prosthetic joint infections. 38,39 There are a variety of agents that can be used for cleansing including; soap (antimicrobial or plain soap); 4% chlorhexidine solution combined with a detergent or in a triclosan preparation; or 2% chlorhexidine-impregnated cloths. 40 There is not sufficient high-quality evidence to recommend use of one over the other.…”