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European Journal of Orthopaedic Surgery & Traumatology

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01-07-2020 | Incision | Original Article

Intraoperative bacterial contamination in total hip and knee arthroplasty is associated with operative duration and peeling of the iodine-containing drape from skin

Authors: Mitsuru Hanada, Kensuke Hotta, Hiroki Furuhashi, Yukihiro Matsuyama

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2020

Abstract

Background

Surgical site infection (SSI) and periprosthetic joint infection are the most important problems after total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study aimed to examine the risk factors for intraoperative bacterial contamination in THA and TKA.

Methods

One hundred and seven hips underwent THA, while 74 knees underwent TKA. After the implant was placed, a swab sample for bacterial culture was collected around the skin incision. At the time of specimen collection, patients were separated into two groups based on whether the iodine-containing drape remained adhered to the skin (group DR) or the iodine-containing drape was peeled off (group ND). Patient characteristics, including age, height, body weight, body mass index, operative duration, intraoperative blood loss, surgical procedures, and condition of the iodine-containing drape, were compared between patients with positive and negative bacterial cultures.

Results

In THA, which had a shorter operative duration than TKA (p < 0.001), there was one case of bacterial contamination. In TKA, there were ten cases of positive bacterial contamination, all in group ND. Postoperative SSI occurred in one case. The binomial logistic regression analyses confirmed that TKA [OR 16.562 (95% CI 2.071 to 132.430), p < 0.01] was a high risk factor of bacterial contamination compared to THA and the group ND [OR 0.000 (95% CI 0.000), p < 0.001] had a low risk of bacterial contamination compared to the group DR. In TKAs, operative duration was the risk factor of bacterial contamination [OR 1.026 (95% CI 1.000 to 1.054), p < 0.01].

Conclusions

Intraoperative bacterial contamination increases in procedures with long operating time and may be suppressed by proper use of an iodine-containing drape.

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Title: Intraoperative bacterial contamination in total hip and knee arthroplasty is associated with operative duration and peeling of the iodine-containing drape from skin
Authors: Mitsuru Hanada
Kensuke Hotta
Hiroki Furuhashi
Yukihiro Matsuyama
Publication date: 01-07-2020
Publisher: Springer Paris
Keywords: Incision
Peeling
Hip-TEP
Hip-TEP
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02653-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intraoperative bacterial contamination in total hip and knee arthroplasty is associated with operative duration and peeling of the iodine-containing drape from skin

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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