Risk Factors for Surgical-Site Infection Following Primary Total Knee Arthroplasty

Minnema, Brian; Vearncombe, Mary; Augustin, Anne Marie; Gollish, Jeffrey; Simor, Andrew E.

doi:10.1086/502425

Cited by 148 publications

(93 citation statements)

References 31 publications

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“…Few studies adhere to these criteria [3,30,35,37]. This requires 12-month followup and we were able to classify cases into deep and superficial infection based on the Centers for Disease Control and Prevention criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous authors have proposed theories [8,12,14,17,28,35,46,48] and risk factors [3,12,30,35] (Table 1) regarding the pathogenesis of infection after joint arthroplasty to prevent and control this condition. However, identification of risk factors often is difficult [3,18,27,30].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors suggest UTI should be treated before the joint arthroplasty [9] whereas others have stated there are no well-documented data to support the association between UTI and joint infection [15,36,41]. Some authors report an association between postoperative bladder catheterization and subsequent joint infection [7,28,30]. However, these data are from case reports or case series [7,28,30] and their validity is questionable [10].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors report an association between postoperative bladder catheterization and subsequent joint infection [7,28,30]. However, these data are from case reports or case series [7,28,30] and their validity is questionable [10].…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Surgical wound infection is a serious and potentially catastrophic complication after joint arthroplasty. Urinary tract infection is a common infection that creates a potential reservoir of resistant pathogens and increases patient morbidity. We asked whether treated preoperative and postoperative urinary tract infections are risk factors for deep joint infection. We examined the medical records of 19,735 patients. The minimum had joint infections develop. Of these, three had preoperative and four had postoperative urinary tract infections. The majority of bacteria were not enteric. The bacteria in the two types of infections were not identical. Control subjects were randomly selected from a list of patients matched with patients having infections. Of these, eight had preoperative and one had postoperative urinary tract infections. We found no association between the preoperative urinary tract infection (odds ratio, 0.341; 95% confidence interval, 0.086-1.357) or postoperative urinary tract infection (odds ratio, 4.222; 95% confidence interval, 0.457-38.9) and wound infection. Only one of the 58 patients with wound infections had a urinary tract infection with the same bacteria in both infections. Given the infection rate was very low (0.29%), the power of the study was only 25%. Although limited, the data suggest patients with urinary tract infections had no more likelihood of postoperative infection. We believe treated urinary tract infection should not be a reason to delay or postpone surgery. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Patel et al [10] estimated that each day of persistent wound drainage increases the risk of infection by 42%. Although many of the risk factors for persistent wound drainage are also independent risk factors for PJI, including malnutrition [4], excess anticoagulation [6], obesity [12], diabetes [21], and a higher American Society of Anesthesiologists score [12], it is also believed that the path that allows fluid to egress from the wound is a potential conduit for retrograde bacterial 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 editors and board members are on file with the publication and can be viewed on request.…”

Section: Introductionmentioning

confidence: 99%

Negative Pressure Wound Therapy Is Associated With Resolution of Incisional Drainage in Most Wounds After Hip Arthroplasty

Hansen

Durinka

Costanzo

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Persistent wound drainage after hip arthroplasty is a risk factor for periprosthetic infection. Negative pressure wound therapy (NPWT) has been used in other fields for wound management although it is unclear whether the technique is appropriate for total hip arthroplasty. Questions/purposes We determined (1) the rate of wound complications related to use of NPWT for persistent incisional drainage after hip arthroplasty; (2) the rate of resolution of incisional drainage using this modality; and (3) risk factors for failure of NPWT for this indication. Methods In a pilot study we identified 109 patients in whom NPWT was used after hip arthroplasty for treating postoperative incisional drainage between April 2006 and April 2010. On average, the NPWT was placed on postoperative Day 3 to 4 (range, 2-9 days) and applied for 2 days (range, 1-10 days). We then determined predictors of subsequent surgery. Patients were followed until failure or a minimum of 1 year (average, 29 months; range, 1-62 months). Results Eighty-three patients (76%) had no further surgery and 26 patients (24%) had subsequent surgery: 11 had superficial irrigation and débridement (I&D), 12 had deep I&D with none requiring further surgery, and three ultimately had component removal. Predictors of subsequent surgery included international normalized ratio level greater than 2, greater than one prior hip surgery, and device application greater than 48 hours. There were no wound-related complications associated with NPWT. Conclusions The majority of our patients had cessation of wound drainage with NPWT.

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Operative Medizin

Grossart

Praktische Krankenhaushygiene Und Umweltschutz

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Risk Factors for Surgical-Site Infection Following Primary Total Knee Arthroplasty

Abstract: The use of closed suction drainage and a high postoperative INR were associated with the development of SSI following TKA. Avoiding the use of surgical drains and careful monitoring of anticoagulant prophylaxis in patients undergoing TKA should reduce the risk of infection.

Cited by 148 publications

References 31 publications

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Negative Pressure Wound Therapy Is Associated With Resolution of Incisional Drainage in Most Wounds After Hip Arthroplasty

Operative Medizin

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