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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 9/2011

01-09-2011 | Orthopaedic Surgery

Comparison of a low-pressure and a high-pressure pulsatile lavage during débridement for orthopaedic implant infection

Authors: E. Muñoz-Mahamud, S. García, G. Bori, J. C. Martínez-Pastor, J. A. Zumbado, J. Riba, J. Mensa, A. Soriano

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2011

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Abstract

Introduction

The aim of our study was to compare the effectiveness of high-pressure pulsatile lavage and low-pressure lavage in patients with an orthopaedic implant infection treated with open débridement followed by antibiotic treatment.

Patients and methods

Patients with an orthopaedic implant infection requiring open débridement from January 2008 to August 2009 were randomized prospectively to a low-pressure or a high-pressure pulsatile lavage arm. Relevant information about demographics, co-morbidity, type of implant, microbiology data, surgical treatment, and outcome were recorded. Comparison of proportions was made using χ2 test or Fisher exact test when necessary. The Kaplan–Meier survival method was used to estimate the cumulative probability of treatment failure from open débridement to the last visit.

Results

Seventy-nine patients were included. There were no differences between the main characteristics between both groups (p > 0.05). Mean (SD) age of the whole cohort was 70.2 (11.9) years. There were 46 infections on knee prosthesis, 17 on hip prosthesis, 7 on hip hemiarthroplasties and 9 on osteosynthesis devices. There were 69 acute post-surgical infections, 8 acute haematogenous infections and 2 chronic infections. The most common microorganisms isolated were coagulase-negative Staphylococci in 34 cases, Staphylococcus aureus in 26 and Escherichia coli in 19 cases. There were 30 polymicrobial infections. A total of 42 and 37 patients were randomized to a high-pressure pulsatile or a low-pressure lavage, respectively. There was no difference in the success rate between both arms (80.9 vs. 86.5%, p = 0.56).

Conclusion

The use of a high-pressure pulsatile lavage during open débridement of implant infections had a similar success rate as a low-pressure lavage.
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Metadata
Title
Comparison of a low-pressure and a high-pressure pulsatile lavage during débridement for orthopaedic implant infection
Authors
E. Muñoz-Mahamud
S. García
G. Bori
J. C. Martínez-Pastor
J. A. Zumbado
J. Riba
J. Mensa
A. Soriano
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-011-1291-8

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