Outbreak of Surgical Wound Infections Associated with Total Hip Arthroplasty

1992 ◽  
Vol 13 (9) ◽  
pp. 526-534 ◽  
Author(s):  
Consuelo M. Beck-Sague ◽  
Wang H. Chong ◽  
Connie Roy ◽  
Roger Anderson ◽  
William R. Jarvis
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Wound Infections ◽  
Surgical Wound ◽  
Total Hip

Outbreak of Surgical Wound Infections Associated With Total Hip Arthroplasty

1992 ◽  
Vol 13 (9) ◽  
pp. 526-534 ◽  
Author(s):  
Consuelo M. Beck-Sague ◽  
Wang H. Chong ◽  
Connie Roy ◽  
Roger Anderson ◽  
William R Jarvis
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Wound Infection ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Surgical Wound Infection ◽  
Wound Infections ◽  
Surgical Wound ◽  
Total Hip ◽  
Drop Plate

AbstractObjectives:Describe an outbreak of surgical wound infections associated with total hip arthroplasty; identify risk factors for surgical wound infection during the pre-outbreak and outbreak periods.Setting:A 100-bed hospital. From May 1 to September 30, 1988, 7 of 15 patients who underwent total hip arthroplasty developed surgical wound infections from Staphylococcus aureus (5), Enterobacter cloacae (1), b-hemolytic streptococci (1), enterococci (1), coagulase-negative staphylococci (1), and Escherichia coli (1) (attack rate = 46.7%).Design:Retrospective cohort studies comparing surgical wound infection rates by patient-and procedure-related risk factors during the pre-outbreak and outbreak periods were conducted. Drop plate quantitative air culturing was conducted in 10 consecutive total hip artbroplasties in the subsequent 6 months.Results:Rates of surgical wound infection were significantly higher for arthroplasties in which no intraoperative prophylactic antimicrobials were given (44% versus 8%, relative risk [RR] = 5.4, p= .01), or in which the posterior approach (20% versus 3%, RR= 6.7, p = .04) or a specific prosthesis (39% versus 5%, RR=6.3, p = 0.01) was used. The surgical wound infection rate was highest when one circulating nurse, Nurse A, assisted (47% versus 4%, RR= 12.8, p<.001). Logistic regression analysis identified use of the posterior approach (RR= 1.8, p= .04) and Nurse A's participation (RR= 5.0, p <.001) as independent risk factors for surgical wound infection. Interviews of the nursing supervisor indicated that Nurse A had recurrent dermatitis on her bands. During 6 months following Nurse A's reassignment, the rate declined significantly (from 7/15 to 0/10, p=.01). Drop plate culturing yielded 2 to 10 colonies per plate of organisms that did not match outbreak organisms.Conclusions:Outbreaks associated with personnel generally involve only 1 species. In this outbreak, Nurse A (possibly because of her dermatitis), technique, the posterior approach, and/or other undetermined factors were the primary predictors of surgical wound infection.

scholarly journals PROGNOSIS OF DEEP INFECTIOUS COMPLICATIONS IN HIP ARTHROPLASTY

2015 ◽  
Vol 174 (5) ◽  
pp. 40-44
Author(s):  
Yu. L. Dorofeev ◽  
D. A. Ptashnikov ◽  
A. N. Tkachenko ◽  
M. Yu. Bakhtin ◽  
A. F. Kalimullina
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Deep Infection ◽  
Infectious Complications ◽  
Surgical Wound ◽  
Total Hip ◽  
Deep Surgical Site Infection ◽  
Primary Total Hip Arthroplasty ◽  
Prospective Investigation

The retrospective research analyzed the data of 893 patients undergoing total hip arthroplasty. There were used the data about patients undergoing hip arthroplasty without complications (the first group - 808 cases) and patients with developed deep surgical site infection following total joint arthroplasty after 12 months (the second group - 85 patients). It was applied as the training matrix in creation of mathematical prognosis and algorithm of prophylaxis of deep infection in patients undergoing the primary total hip arthroplasty. There were revealed 21 prognostic significant criteria of deep infection development in surgical site. The program was tested in prospective investigation (293 clinical cases) with follow-up term of 12 months after operation. The rate of development of postoperative deep infection in surgical wound reduced as compared with the rate in group of retrospective research from 1,7% to 0,7%. The efficacy of proposed program was 80%.

MR Imaging with Metal Artifact Reduction to Differentiate between Patients with and without Infected Total Hip Arthroplasty

2018 ◽  
Author(s):  
Benedikt Schwaiger ◽  
Alexandra Gersing ◽  
Daniela Muenzel ◽  
Julia Dangelmaier ◽  
Peter Prodinger ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Mr Imaging ◽  
Hip Arthroplasty ◽  
Artifact Reduction ◽  
Metal Artifact ◽  
Metal Artifact Reduction ◽  
Total Hip

Plasma Prekallikrein Activity in Patients with Total Hip Arthroplasty

1987 ◽  
Vol 58 (04) ◽  
pp. 1040-1042
Author(s):  
J J M L Hoffmann ◽  
J H J P M Kortmann
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Contact System ◽  
Factor Xii ◽  
Total Hip ◽  
Activity Factor ◽  
Patient Groups ◽  
Kallikrein Activity

SummaryThe behaviour of the contact system was studied in 40 patients with total hip arthroplasty, by measuring plasma prekallikrein, spontaneous kallikrein activity and factor XII. In the literature it had been shown that patients with complications from this operation had decreased prekallikrein and increased kallikrein activity (M. Nakahara. Acta orthop scand 1982; 53: 591-6). In the present study, comprising patients with and without pain and proven loosening of the hip prosthesis, these findings could only partially be confirmed. Patients with a loosened prosthesis had significantly lower prekallikrein (mean 0.78 ± 0.28 U/ml; p <0.01) than patients without problems, but no detectable kallikrein activity in plasma. Patients with pain but no loosening had normal prekallikrein (1.04 ±0 0.26 U/ml) and also no demonstrable kallikrein activity. Factor XII was normal in all patient groups. It is concluded that decreased prekallikrein is limited to patients with a loosened hip prosthesis, with or without pain.

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