Intraoperative and Postoperative Infection Prevention

Goswami, Karan; Stevenson, Kimberley L.; Parvızı, Javad

doi:10.1016/j.arth.2019.10.061

Cited by 26 publications

(26 citation statements)

References 128 publications

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“…Orthopaedic surgeries, such as hip and knee prosthesis, are among the highest cumulative incidences of SSI [ 5 ]. SSI may lead to an osseous infection, followed by a systemic infection, which requires the usage of perioperative antibiotic prophylaxis (PAP) to reduce the risk of infection [ 8 , 9 ]. PAP consists of a short-term administration of antibiotics directly before surgery (during the induction of anesthetic before skin incision).…”

Section: Introductionmentioning

confidence: 99%

Modifications of Hydroxyapatite by Gallium and Silver Ions—Physicochemical Characterization, Cytotoxicity and Antibacterial Evaluation

Pajor

Pajchel

Zgadzaj

et al. 2020

IJMS

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Hydroxyapatite (HA) powders enriched with silver or gallium ions or both were synthesized by two different routes: standard precipitation and the solid-state method. The powders were characterized by using several methods: inductively coupled plasma optical emission spectrometry (ICP-OES), powder X-ray diffractometry (PXRD), transmission electron microscopy (TEM), infrared spectroscopy (FT-IR) and solid-state nuclear magnetic resonance spectroscopy (ssNMR). The effects of enrichment of the HAs in Ag+ or Ga3+ or both on in vitro cytotoxicity and microbiological activity were discussed. PXRD experiments showed that the samples obtained by the wet method consisted of single-phase nanocrystalline HA, while the samples prepared via the solid-state method are microcrystalline with a small amount of calcium oxide. The introduction of higher amounts of silver ions was found to be more effective than enriching HA with small amounts of Ag+. Gallium and silver ions were found not to affect the lattice parameters. Ga3+ affected the crystallinity of the samples as well as the content of structural hydroxyl groups. Among samples synthesized by the wet method, only one (5Ag-HAw) was cytotoxic, whereas all Ga-containing samples obtained by the dry method showed cytotoxicity. In the preliminary antimicrobial test all the materials containing “foreign” ions showed high antibacterial activity.

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Section: Introductionmentioning

confidence: 99%

Modifications of Hydroxyapatite by Gallium and Silver Ions—Physicochemical Characterization, Cytotoxicity and Antibacterial Evaluation

Pajor

Pajchel

Zgadzaj

et al. 2020

IJMS

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“…Se disponíveis e aconselhados pela equipa técnica da instituição, podem ser instalados filtros HEPA com capacidade para remover aerossóis e gotículas no interior da sala de operações. 5 Tendo em conta as características de disseminação do vírus e o risco acrescido de contágio em resultado da manipulação da via aérea, 1,21,24,25 apenas as pessoas indispensáveis para a realização da entubação devem estar presentes na sala de bloco operatório. A anestesia loco-regional deverá ser usada preferencialmente, sempre que considerada adequada do ponto de vista técnico.…”

Section: Intra Operatório 431 Sala De Operaçõesunclassified

“…A anestesia loco-regional deverá ser usada preferencialmente, sempre que considerada adequada do ponto de vista técnico. [22][23][24][25][26] A anestesia loco--regional não é no entanto isenta de risco de contágio, uma vez que pode continuar a ocorrer a formação de aerossóis, por exemplo, com a utilização de cânula nasal de alto fluxo de oxigénio. 26 Nessas circunstâncias, a equipa de anestesia deve usar fato de proteção adequado durante todo o procedimento.…”

Section: Intra Operatório 431 Sala De Operaçõesunclassified

Como Retomar a Atividade Cirúrgica Eletiva em Ortopedia durante a Pandemia COVID-19?

et al. 2021

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This document was prepared by the College of Orthopedics of the Portuguese Medical Association with the aim of developing the guidelines on the resumption of elective surgical activity in Orthopedics during the COVID-19 pandemic. It sets the criteria that allow the prioritization of surgeries according to the severity of the clinical situation, based on existing and published classifications. Moreover, it provides an organizational model for patient preparation and describes the patient pathways in the preoperative, intraoperative and postoperative periods. It also describes safety rules for elective surgery and a model for monitoring patients after discharge according to scientific evidence.

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“…Infection following TKA is often accompanied by synovitis, and a specific pattern of synovitis has been reported to be a characteristic sign of infected TKA [8][9][10]. Although specific treatment strategies may differ depending on the type and causative microorganism of infection [11][12][13], synovectomy is an essential surgical procedure in most revision surgeries. However, there is a paucity of published studies describing detailed synovectomy techniques.…”

Section: Introductionmentioning

confidence: 99%

A novel open synovectomy technique using an arthroscopy shaver blade in revision surgery to treat infected total knee arthroplasty: a technical note

Lee

Kim

2022

J Orthop Surg Res

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Background This article introduces a novel open synovectomy technique using an arthroscopy shaver blade to effectively remove intra-articular synovitis during revision surgery for infected primary total knee arthroplasty. Methods (techniques) Open synovectomy is performed using a 4.2-mm arthroscopy shaver blade, and the handpiece is connected to suction drainage. Suction is supplied through the central cylinder of the shaver blade to bring the debrided fragments of soft tissue into the window. Grossly inflamed, reddened, diseased synovium is debrided to reveal yellowish, healthy synovium. The inflamed tissues of the knee joint (suprapatellar pouch, medial and lateral gutters, and peripatellar area) are debrided. Then, with maintaining full flexion of the knee joint, a shaver equipped with a longer bar can be used to easily access the medial and lateral posterior compartments, which are generally difficult to access. Results During a mean of 13.5-month follow-up, there was no recurrent infection in either group; however, patients who underwent the novel technique improved significantly faster in terms of acute serological markers during the first period. Conclusions This technique yielded favorable outcomes compared with the conventional technique. In particular, it may facilitate the approach to the posterior joint space, which is difficult to access.

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Intraoperative and Postoperative Infection Prevention

Cited by 26 publications

References 128 publications

Modifications of Hydroxyapatite by Gallium and Silver Ions—Physicochemical Characterization, Cytotoxicity and Antibacterial Evaluation

Modifications of Hydroxyapatite by Gallium and Silver Ions—Physicochemical Characterization, Cytotoxicity and Antibacterial Evaluation

Como Retomar a Atividade Cirúrgica Eletiva em Ortopedia durante a Pandemia COVID-19?

A novel open synovectomy technique using an arthroscopy shaver blade in revision surgery to treat infected total knee arthroplasty: a technical note

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