Infection after total hip replacement. With special reference to a discharge from the wound

Surin, VV; Sundholm, Krister; Bäckman, Lars

doi:10.1302/0301-620x.65b4.6874711

Cited by 132 publications

(82 citation statements)

References 5 publications

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“…As previously reported in other series the most common organisms responsible for wound infection are Staphylococcus aureus and Staphylococcus epidermidis [2,20,22]. In this series 81% of all wound infection was due to staphylococci, either in pure forms or in mixed culture with other organisms.…”

Section: Discussionsupporting

confidence: 73%

The outcome of perioperative wound infection after total hip and knee arthroplasty

Abudu

Sivardeen

Grimer

et al. 2001

International Orthopaedics (SICOT)

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Forty-one consecutive patients with primary knee arthroplasty and 37 with primary hip arthroplasty, all with perioperative wound infections, were followed for 50 (12-130) months. Staphylococci (coagulase negative and positive) accounted for 74% of wound infections. Mixed organisms accounted for 10%. Prosthetic infections developed in eight patients and aseptic loosening in three patients. All the prosthetic infections developed within 6 months of the primary surgery. Organisms responsible for superficial infections were responsible for prosthetic infection in five patients; no organisms were isolated in the remaining three patients. The presence or absence of wound dehiscence, wound haematoma, and postoperative pyrexia did not predict the development of deep sepsis; however, the presence of wound discharge was a significant risk factor. Résumé Une série de patients consécutifs présentant une infection péri-opératopire ont été suivis pendant 50 (12 à 130) mois ; 41 après une arthroplastie primaire du genou et 37 après une arthroplastie primaire de la hanche. Le staphylocoque (coagulase positif et negatif) était en cause dans 74% des cas. Dans 10% des cas plusieurs germes étaient en cause. Les infections sur prothèse se sont développées chez huit patients et il y eu un descellement aseptique chez trois patients. Toutes les infections sur prothèse se sont développées dans les six mois suivant la chirurgie primaire. Les germes responsables des infections superficielles étaient responsables de l'infection sur prothèse chez cinq patients. Aucun germe n'a été isolé chez les trois autre patients. La présence d'une déhiscence de la plaie, l'existence d'un hématome ou la pyrexie postopératoires n'avaient pas de valeur prédictive pour le développement d'un sepsis profond mais la présence d'un écoulement de la plaie opératoire était un facteur de risque considérable.

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Section: Discussionsupporting

confidence: 73%

The outcome of perioperative wound infection after total hip and knee arthroplasty

Abudu

Sivardeen

Grimer

et al. 2001

International Orthopaedics (SICOT)

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“…This procedure salvaged 3 out of the 4 hip replacements with these complications in our series. A positive urinary tract culture was associated with septic arthritis, as has been reported in other series (Fitzgerald et al 1977, Surin et al 1983), although one other study did not find a significant relationship (Hill et al 1981). Usually no clear correlation can be found between the pathogens of urinary tract infections and hip septic arthritis, so a causal relationship cannot be established.…”

Section: Discussionsupporting

confidence: 52%

“…In hip arthroplasty, diabetes was associated with septic arthritis (Nelson 1987), but not always (Fitzgerald et al 1977). As in many other studies, failed fracture osteosynthesis was a risk factor for septic arthritis (Fitzgerald et al 1977, Nelson 1980, Andrews et al 1981, Surin et al 1983, Poss et al 1984. except in two large series (Salvati et al 1982, Lidwell et al 1984.…”

Section: Discussionmentioning

confidence: 66%

Perioperative factors associated with septic arthritis after arthroplasty

Wymenga¹,

Horn²,

Theeuwes³

et al. 1992

Acta Orthopaedica Scandinavica

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“…Our findings, taken together with previous studies, suggest that surgeons should think carefully before performing this elective procedure in a patient with HbA 1C C 8 or FBG C 200 mg. Although no patients in our study developed deep infection, which prevents us from evaluating the association of poor glycemic control with deep infection, previous studies reported that patients who develop superficial surgical site infection are at greater risk for deep periprosthetic joint infection [3,24,26].…”

Section: Discussionmentioning

confidence: 62%

Do Glycemic Markers Predict Occurrence of Complications After Total Knee Arthroplasty in Patients With Diabetes?

Hwang

Kim

Bamne

et al. 2015

Clinical Orthopaedics &Amp; Related Research

109

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Background Patients with diabetes have increased risk of infections and wound complications after total knee arthroplasty (TKA). Glycemic markers identifying patients at risk for complications after TKA have not yet been elucidated. Questions/purposes We aimed to determine the correlations among four commonly used glycemic markers and to identify the glycemic markers most strongly associated with the occurrence of surgical site infections and postoperative wound complications in patients with diabetes mellitus after undergoing TKA. Methods Our retrospective study included 462 patients with diabetes, who underwent a total of 714 TKAs. Blood levels of glycemic markers, including preoperative fasting blood glucose (FBG), postprandial glucose (PPG2), glycated hemoglobin (HbA 1c ), and levels obtained from random glucose testing on postoperative days 2, 5, and 14, were collected on all patients as part of a medical clearance program and an established clinical pathway for patients with diabetes at our center. Complete followup was available on 93% (462 of 495) of the patients. Correlations among markers were assessed. Associations between the markers and patient development of complications were analyzed using multivariate regression analyses of relevant cutoff values. We considered any of the following as complications potentially related to diabetes, and these were considered study endpoints: surgical site infection (superficial and deep) and wound complications (drainage, hemarthrosis, skin necrosis, and dehiscence). During the period of study, there were no fixed criteria applied to what levels of glycemic control patients with diabetes needed to achieve before undergoing arthroplasty, and there were wide ranges in the levels of all glycemic markers; for example, whereas the mean HbA 1c level was 7%, the range was 5% to 11.3%.Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained. This work was performed at the Joint Reconstruction Center, Seoul National University Bundang Hospital, Seoul, Republic of Korea. Results There were positive correlations among the levels of the four glycemic markers; the strongest correlation was found between the preoperative HbA 1c and PPG2 levels (R = 0.502, p \ 0.001). After controlling for potential confounding variables using multivariate analysis, the HbA 1c cutoff level of 8 (odds ratio [OR], 6.1; 95% confidence interval...

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Infection after total hip replacement. With special reference to a discharge from the wound

Cited by 132 publications

References 5 publications

The outcome of perioperative wound infection after total hip and knee arthroplasty

The outcome of perioperative wound infection after total hip and knee arthroplasty

Perioperative factors associated with septic arthritis after arthroplasty

Do Glycemic Markers Predict Occurrence of Complications After Total Knee Arthroplasty in Patients With Diabetes?

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