Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 5/2012

01-10-2012 | Skin, Soft Tissue, Bone and Joint Infections (N Safdar, Section Editor)

Prevention of Surgical Site Infections in Bone and Joint Procedures

Authors: Ralf-Peter Vonberg, Petra Gastmeier

Published in: Current Infectious Disease Reports | Issue 5/2012

Login to get access

Abstract

There is strong evidence that preoperative nasal S. aureus screening/decolonization will significantly reduce surgical site infections (SSIs) after joint prostheses implantation. There is some evidence that antibiotic-containing bone cement may lower SSI rates. Timely administration of perioperative systemic antibiotic prophylaxis is recommended for patients with implants who are undergoing dental treatment, urogenital surgery, upper endoscopy, sigmoidoscopy, or colonoscopy. Advanced skin disinfection by chlorhexidine-gluconate-impregnated cloths may be protective. There is evidence that clippers are favored for hair removal, rather than razors, but no significant advantage, as compared with other modes of hair removal, has been found. Antibiotic-coated intramedullary nails and antibiotic-impregnated bone grafts may be useful for the treatment of chronic bone infections. No recommendation can be made for wound dressing types. Laminar air flow systems do not seem to prevent SSI but may even cause harm, instead. There is a strong association between the annual number of surgical procedures and low SSI rates.
Literature
1.
Gastmeier P, Breier AC, Sohr D, Geffers C. Prevention of surgical site infections - results from 14 years of KISS. Trauma Berufskrankh. 2012;in press.
2.
Huenger F, Schmachtenberg A, Haefner H, et al. Evaluation of postdischarge surveillance of surgical site infections after total hip and knee arthroplasty. Am J Infect Control. 2005;33:455–62.PubMedCrossRef
3.
Castella A, Argentero PA, Farina EC, Charrier L, Del Prever EM, Zotti CM. Incidence of surgical-site infections in orthopaedic surgery: a northern Italian experience. Epidemiol Infect. 2011;139:777–82.PubMedCrossRef
4.
Gastmeier P, Sohr D, Brandt C, Eckmanns T, Behnke M, Ruden H. Reduction of orthopaedic wound infections in 21 hospitals. Arch Orthop Trauma Surg. 2005;125:526–30.PubMedCrossRef
5.
Geubbels EL, Nagelkerke NJ. Mintjes-De Groot AJ, Vandenbroucke-Grauls CM, Grobbee DE, and De Boer AS. Reduced risk of surgical site infections through surveillance in a network. Int J Qual Health Care. 2006;18:127–33.PubMedCrossRef
6.
Astagneau P, L'Heriteau F, Daniel F, et al. Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system. J Hosp Infect. 2009;72:127–34.PubMedCrossRef
7.
Hacek DM, Robb WJ, Paule SM, Kudrna JC, Stamos VP, Peterson LR. Staphylococcus aureus nasal decolonization in joint replacement surgery reduces infection. Clin Orthop Relat Res. 2008;466:1349–55.PubMedCrossRef
8.
• Bode LG, Kluytmans JA, Wertheim HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362:9–17. A randomized, double-blind, placebo-controlled, multicenter trial showed that screening of 6,771 patients and decolonizing nasal carriers significantly lowered the nosocomial SSI S. aureus infection rate (3.4% vs. 7.7%).PubMedCrossRef
9.
Ramos N, Skeete F, Haas JP, et al. Surgical site infection prevention initiative - patient attitude and compliance. Bull NYU Hosp Jt Dis. 2011;69:312–5.PubMed
10.
• Rao N, Cannella BA, Crossett LS, Yates Jr AJ, McGough III RL, Hamilton CW. Preoperative screening/decolonization for Staphylococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up. J Arthroplasty. 2011;26:1501–7. Overall SSI rates in elective total joint arthroplasty were significantly lowered by a S. aureus screening and decolonization programme in 2,284 patients (1.2% vs. 3.3%). No S. aureus infections were observed in previously decolonized patients.PubMedCrossRef
11.
Murphy E, Spencer SJ, Young D, Jones B, Blyth MJ. MRSA colonisation and subsequent risk of infection despite effective eradication in orthopaedic elective surgery. J Bone Joint Surg Br. 2011;93:548–51.PubMed
12.
• Uckay I, Lubbeke A, Harbarth S, et al. Low risk despite high endemicity of methicillin-resistant Staphylococcus aureus infections following elective total joint arthroplasty: a 12-year experience. Ann Med. 2011;in press. Despite highly endemic MRSA (30%) there were only 7 MRSA infections in patients undergoing elective knee and hip joint arthroplasties in a 12-year prospective cohort study including 4,001 hip prostheses, 2,099 knee prostheses, and 441 revisions.
13.
Pofahl WE, Goettler CE, Ramsey KM, Cochran MK, Nobles DL, Rotondo MF. Active surveillance screening of MRSA and eradication of the carrier state decreases surgical-site infections caused by MRSA. J Am Coll Surg. 2009;208:981–6.PubMedCrossRef
14.
• Slover J, Haas JP, Quirno M, Phillips MS, Bosco III JA. Cost-effectiveness of a Staphylococcus aureus screening and decolonization program for high-risk orthopedic patients. J Arthroplasty. 2011;26:360–5. Preoperative S. aureus screening and decolonization in 365 hip and knee arthroplasties required an estimated 35% reduction of the number of revisions in order to be cost-effective in a Markov decision analysis if the cost of treating the infection equals the cost of the primary insertion of the prosthesis.PubMedCrossRef
15.
• Courville XF, Tomek IM, Kirkland KB, Birhle M, Kantor SR, Finlayson SR. Cost-effectiveness of preoperative nasal mupirocin treatment in preventing surgical site infection in patients undergoing total hip and knee arthroplasty: a cost-effectiveness analysis. Infect Control Hosp Epidemiol. 2012;33:152–9. Empirical treatment with mupirocin ointment or nasal S. aureus screening (and treatment if applicable) was cost-effective and reduces the risk of SSI in a hypothetical cohort of patients who plan recieving total joint arthroplasty.PubMedCrossRef
16.
McHugh SM, Collins CJ, Corrigan MA, Hill AD, Humphreys H. The role of topical antibiotics used as prophylaxis in surgical site infection prevention. J Antimicrob Chemother. 2011;66:693–701.PubMedCrossRef
17.
Yarboro SR, Baum EJ, Dahners LE. Locally administered antibiotics for prophylaxis against surgical wound infection. An in vivo study. J Bone Joint Surg Am. 2007;89:929–33.PubMedCrossRef
18.
Anglen JO. Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study. J Bone Joint Surg Am. 2005;87:1415–22.PubMedCrossRef
19.
Moehring HD, Gravel C, Chapman MW, Olson SA. Comparison of antibiotic beads and intravenous antibiotics in open fractures. Clin Orthop Relat Res. 2000;372:254–61.PubMedCrossRef
20.
Meek RM, Dunlop D, Garbuz DS, McGraw R, Greidanus NV, Masri BA. Patient satisfaction and functional status after aseptic versus septic revision total knee arthroplasty using the PROSTALAC articulating spacer. J Arthroplasty. 2004;19:874–9.PubMedCrossRef
21.
Jiranek WA, Hanssen AD, Greenwald AS. Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement. J Bone Joint Surg Am. 2006;88:2487–500.PubMedCrossRef
22.
Tunney MM, Dunne N, Einarsson G, McDowell A, Kerr A, Patrick S. Biofilm formation by bacteria isolated from retrieved failed prosthetic hip implants in an in vitro model of hip arthroplasty antibiotic prophylaxis. J Orthop Res. 2007;25:2–10.PubMedCrossRef
23.
Andollina A, Bertoni G, Zolezzi C, et al. Vancomycin and meropenem in acrylic cement: elution kinetics of in vitro bactericidal action. Chir Organi Mov. 2008;91:153–8.PubMedCrossRef
24.
Parvizi J, Saleh KJ, Ragland PS, Pour AE, Mont MA. Efficacy of antibiotic-impregnated cement in total hip replacement. Acta Orthop. 2008;79:335–41.PubMedCrossRef
25.
Dairaku K, Takagi M, Kawaji H, Sasaki K, Ishii M, Ogino T. Antibiotics-impregnated cement spacers in the first step of two-stage revision for infected totally replaced hip joints: report of ten trial cases. J Orthop Sci. 2009;14:704–10.PubMedCrossRef
26.
• Cabo J, Euba G, Saborido A, et al. Clinical outcome and microbiological findings using antibiotic-loaded spacers in two-stage revision of prosthetic joint infections. J Infect. 2011;63:23–31. In a prospective study (42 patients) of prosthetic joint infections second-stage revision cultures were often non-sterile at reimplantation. Positive antibiotic-loaded spacer cultures together with tissue cultures helped to diagnose second-stage infections when clinical signs were absent. PubMedCrossRef
27.
• Fei J, Liu GD, Yu HJ, Zhou YG, Wang Y. Antibiotic-impregnated cement spacer versus antibiotic irrigating metal spacer for infection management after THA. Orthopedics. 2011;34:172. Compared to an antibiotic irrigating metal spacer antibiotic-impregnated cement spacer was superior in terms of operation time (2.3 vs. 3.3 h), blood loss (1,085 vs. 1,965 mL), hospital stay (24.4 vs. 51.4 d) and function before the second step of a two stage revision of an infected total hip arthroplasty (Harris Hip Score 88.2 vs. 79.5), and long term irrigation.PubMed
28.
Gooding CR, Masri BA, Duncan CP, Greidanus NV, Garbuz DS. Durable infection control and function with the PROSTALAC spacer in two-stage revision for infected knee arthroplasty. Clin Orthop Relat Res. 2011;469:985–93.PubMedCrossRef
29.
Wilson MA. Skin and soft-tissue infections: impact of resistant gram-positive bacteria. Am J Surg. 2003;186:35S–41S.PubMedCrossRef
30.
Sewick A, Makani A, Wu C, O'Donnell J, Baldwin KD, Lee GC. Does dual antibiotic prophylaxis better prevent surgical site infections in total joint arthroplasty? Clin Orthop Relat Res. 2012;in press.
31.
Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992;326:281–6.PubMedCrossRef
32.
van Kasteren ME, Mannien J, Ott A, Kullberg BJ, De Boer AS, Gyssens IC. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis. 2007;44:921–7.PubMedCrossRef
33.
•• Gillespie WJ, Walenkamp GH. Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures. Cochrane Database Syst Rev. 2010;CD000244. 23 studies (8,447 patients undergoing surgery for closed fracture fixation) got included in a meta-analysis. A single dose of antibiotic prophylaxis significantly reduced the number of deep SSI (RR=0.40; 95%CI: 0.24 – 0.67), superficial SSI, and other types of infection. Multiple dose prophylaxis also decreased the incidence of deep SSI (RR=0.35; 95%CI: 0.19 – 0.62), but failed confirming other infection reduction rates.
34.
Kuong EE, Ng FY, Yan CH, Fang CX, Chiu PK. Antibiotic prophylaxis after total joint replacements. Hong Kong Med J. 2009;15:458–62.PubMed
35.
de Beer J, Petruccelli D, Rotstein C, Weening B, Royston K, Winemaker M. Antibiotic prophylaxis for total joint replacement surgery: results of a survey of Canadian orthopedic surgeons. Can J Surg. 2009;52:E229–34.PubMed
36.
Szell M, Hofmann S, Pietsch M, Gerhart E, Wenisch C. Perioperative antibiotic prophylaxis. Use in orthopaedics. Orthopade. 2006;35:805–12.PubMedCrossRef
37.
SPILF, CMIT, GPIP, et al. Recommendations for bone and joint prosthetic device infections in clinical practice (prosthesis, implants, osteosynthesis). Societe de Pathologie Infectieuse de Langue Francaise. Med Mal Infect. 2010;40:185–211.CrossRef
38.
39.
Napenas JJ, Lockhart PB, Epstein JB. Comment on the 2009 American Academy of Orthopaedic Surgeons' information statement on antibiotic prophylaxis for bacteremia in patients with joint replacements. J Can Dent Assoc. 2009;75:447–9.PubMed
40.
Borgey F, Thibon P, Ertzscheid MA, et al. Pre-operative skin preparation practices: results of the 2007 French national assessment. J Hosp Infect. 2012;in press.
41.
Zywiel MG, Daley JA, Delanois RE, Naziri Q, Johnson AJ, Mont MA. Advance pre-operative chlorhexidine reduces the incidence of surgical site infections in knee arthroplasty. Int Orthop. 2011;35:1001–6.PubMedCrossRef
42.
Johnson AJ, Daley JA, Zywiel MG, Delanois RE, Mont MA. Preoperative chlorhexidine preparation and the incidence of surgical site infections after hip arthroplasty. J Arthroplasty. 2010;25:98–102.PubMedCrossRef
43.
Jakobsson J, Perlkvist A, Wann-Hansson C. Searching for evidence regarding using preoperative disinfection showers to prevent surgical site infections: a systematic review. Worldviews Evid Based Nurs. 2011;8:143–52.PubMedCrossRef
44.
• Tschudin-Sutter S, Frei R, Egli-Gany D, et al. No risk of surgical site infections from residual bacteria after disinfection with povidone-iodine-alcohol in 1014 cases: a prospective observational study. Ann Surg. 2012;255:565–9. PVP-iodine-alcohol for skin disinfection of the preoperative site showed appropriate in 1,005 patients from various surgical disciplines in order to prevent postoperative SSI as remaining bacteria after standardized 3-step disinfection did not correlate with SSI development (overall SSI rate: 4.04%).PubMedCrossRef
45.
Wistrand C, Nilsson U. Effects and experiences of warm versus cold skin disinfection. Br J Nurs. 2011;20:148–51.PubMed
46.
Levent T, Vandevelde D, Delobelle JM, et al. Infection risk prevention following total knee arthroplasty. Orthop Traumatol Surg Res. 2010;96:49–56.PubMedCrossRef
47.
•• Tanner J, Norrie P, Melen K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev. 2011;11:CD004122. 14 trials (17 comparisons) got included in a meta-analysis. The authors found no statistically significant effect on SSI rates depending on the type of hair removal (shaving, clipping, or depilatory cream) but numbers of patients were too low for a final conclusion. Existing evidence suggests that clippers are associated with fewer SSIs than razors.PubMed
48.
Nizegorodcew T, Palmieri G, Marzetti E. Antibiotic-coated nails in orthopedic and trauma surgery: state of the art. Int J Immunopathol Pharmacol. 2011;24:125–8.PubMed
49.
Winkler H, Kaudela K, Stoiber A, Menschik F. Bone grafts impregnated with antibiotics as a tool for treating infected implants in orthopedic surgery - one stage revision results. Cell Tissue Bank. 2006;7:319–23.PubMedCrossRef
50.
Winkler H. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft. Int J Med Sci. 2009;6:247–52.PubMedCrossRef
51.
Winkler H, Stoiber A, Kaudela K, Winter F, Menschik F. One stage uncemented revision of infected total hip replacement using cancellous allograft bone impregnated with antibiotics. J Bone Joint Surg Br. 2008;90:1580–4.PubMedCrossRef
52.
Minnema B, Vearncombe M, Augustin A, Gollish J, Simor AE. Risk factors for surgical-site infection following primary total knee arthroplasty. Infect Control Hosp Epidemiol. 2004;25:477–80.PubMedCrossRef
53.
Parker MJ, Roberts CP, Hay D. Closed suction drainage for hip and knee arthroplasty. A meta-analysis. J Bone Jt Surg Am. 2004;86-A:1146–52.
54.
• Peel TN, Dowsey MM, Daffy JR, Stanley PA, Choong PF, Buising KL. Risk factors for prosthetic hip and knee infections according to arthroplasty site. J Hosp Infect. 2011;79:129–33. A case-control study (prosthetic joint infections of 36 hips and 27 knees compared to 1:2-matched controls) came up with the following risk factors for a SSI: (1) Knee arthroplasty: Wound discharge increased the risk while drain tubes reduced the risk. (2) Hip arthroplasty: increased body mass index, increased drain tube loss and superficial incisional SSI increased the risk.PubMedCrossRef
55.
Siah CJ, Yatim J. Efficacy of a total occlusive ionic silver-containing dressing combination in decreasing risk of surgical site infection: an RCT. J Wound Care. 2011;20:561–8.PubMed
56.
Leaper D, Nazir J, Roberts C, Searle R. Economic and clinical contributions of an antimicrobial barrier dressing: a strategy for the reduction of surgical site infections. J Med Econ. 2010;13:447–52.PubMedCrossRef
57.
•• Dumville JC, Walter CJ, Sharp CA, Page T. Dressings for the prevention of surgical site infection. Cochrane Database Syst Rev. 2011;CD003091. 16 randomized controlled trials (2,578 patients) got included in this meta-analysis. The authors found no evidence that covering surgical wounds healing by primary intention with wound dressings reduces the risk of SSI or that any particular wound dressing is more effective than others in reducing SSI rates, improving scarring, pain control, patient acceptability or ease of dressing removal, but numbers of patients were low and several studies were of poor quality.
58.
Sehulster L, Chinn RY. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 2003;52:1–42.PubMed
59.
• Hooper GJ, Rothwell AG, Frampton C, Wyatt MC. Does the use of laminar flow and space suits reduce early deep infection after total hip and knee replacement?: the ten-year results of the New Zealand Joint Registry. J Bone Jt Surg Br. 2011;93:85–90. Over 10 years 51,485 primary total hip and 36,826 primary total knee replacements were analyses. Independently of age, disease, operating time, surgeons and hospital the rate of revisions for early deep SSI was not reduced by the use of LAF.
60.
• Breier AC, Brandt C, Sohr D, Geffers C, Gastmeier P. Laminar airflow ceiling size: no impact on infection rates following hip and knee prosthesis. Infect Control Hosp Epidemiol. 2011;32:1097–102. 33,463 elective (athrotic) hip prostheses from 48 hospital and additional 7,749 urgent (fracture) hip prostheses form 41 hospitals, and 20,553 knee prostheses from 38 hospitals got included in a cohort study using multivariate analysis. Neither LAF nor the size of the LAF ceiling was associated with lower SSI risk in any of the above mentioned types of surgery.PubMedCrossRef
61.
Kakwani RG, Yohannan D, Wahab KH. The effect of laminar air-flow on the results of Austin-Moore hemiarthroplasty. Injury. 2007;38:820–3.PubMedCrossRef
62.
Brandt C, Hott U, Sohr D, Daschner F, Gastmeier P, Ruden H. Operating room ventilation with laminar airflow shows no protective effect on the surgical site infection rate in orthopedic and abdominal surgery. Ann Surg. 2008;248:695–700.PubMedCrossRef
63.
• Gastmeier P, Breier AC, Brandt C. Laminar airflow or not laminar airflow? That is the question - A systematic review of cohort studies investigating the influence of LAF on severe surgical site infections. J Hosp Infect. 2012; in press. A systematic review including 4 cohort studies on the influence of LAF on the incidence of SSI following hip and knee prostheses calculated an increased (!) risk for SSI development when using LAF (OR=1.36; CI95%: 1.06 – 1.74 for knee prosthesis. OR=1.71; CI95%: 1.21 – 2.41 for hip prosthesis).
64.
McGovern PD, Albrecht M, Belani KG, et al. Forced-air warming and ultra-clean ventilation do not mix: an investigation of theatre ventilation, patient warming and joint replacement infection in orthopaedics. J Bone Joint Surg Br. 2011;93:1537–44.PubMedCrossRef
65.
Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725–32.PubMedCrossRef
66.
Berenholtz SM, Pham JC, Thompson DA, et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit. Infect Control Hosp Epidemiol. 2011;32:305–14.PubMedCrossRef
67.
• Hawn MT, Vick CC, Richman J, et al. Surgical site infection prevention: time to move beyond the surgical care improvement program. Ann Surg. 2011;254:494–9. 60,853 surgical procedures from 112 hospitals were analyzed for adherence to 5 measures from the Surgical Care Improvement Project (SCIP) guidelines. Adherence ranged from 75% to 99% and improved significantly of the study period, but was neither associated with lower SSI rates at the patient level, nor associated with hospital SSI rates.PubMedCrossRef
68.
• Bozic KJ, Maselli J, Pekow PS, Lindenauer PK, Vail TP, Auerbach AD. The influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am. 2010;92:2643–52. 182,146 patients who underwent primary total joint arthroplasty over 2 years performed by 3,421 physicians in 312 hospitals got included in a multivariate analysis. A high number of procedures performed by an individual surgeon were associated with lower risk of complications, lower rates of readmission and reoperation, shorter length of hospital stay, and higher likelihood of being discharged home. A high number of procedures performed in a specific hospital were associated with lower risk of mortality, lower risk of readmission, and higher likelihood of being discharged home.PubMedCrossRef
69.
• Katz JN, Wright EA, Wright J, et al. Choice of hospital for revision total hip replacement. J Bone Joint Surg Am. 2010;92:2829–34. A total of 4,448 revision procedures after total hip replacement were performed in hospitals with annually volume stratums of ≤50, 51 to 100, and >100 surgical procedures. The ratio of revisions performed compared to revisions generated was 1.21 for the highest-volume centers and 0.86 for the lowest-volume centers.PubMedCrossRef
70.
• Meyer E, Weitzel-Kage D, Sohr D, Gastmeier P. Impact of department volume on surgical site infections following arthroscopy, knee replacement or hip replacement. BMJ Qual Saf. 2011;20:1069–74. A total of 14,339 arthroscopies, 63,045 knee replacements and 43,180 hip replacements were performed in 206 surgical departments with annually volume stratums of ≤50, 51 to 100, and >100 surgical procedures. Multivariate analysis with linear regression showed that the risk of SSI in low volume departments was 7-times higher for arthroscopies and 2-time higher for knee replacement compared to medium volume departments. SSI risk after hip replacement was significantly lower in high volume centres.PubMedCrossRef
Metadata
Title
Prevention of Surgical Site Infections in Bone and Joint Procedures
Authors
Ralf-Peter Vonberg
Petra Gastmeier
Publication date
01-10-2012
Publisher
Current Science Inc.
Published in
Current Infectious Disease Reports / Issue 5/2012
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-012-0278-0

Other articles of this Issue 5/2012

Current Infectious Disease Reports 5/2012 Go to the issue

Sepsis (J Russell, Section Editor)

Toll-Like Receptors and Opportunities for New Sepsis Therapeutics

Skin, Soft Tissue, Bone and Joint Infections (N Safdar, Section Editor)

Chronic Osteomyelitis

Sepsis (J Russell, Section Editor)

Variability Analysis and the Diagnosis, Management, and Treatment of Sepsis

Skin, Soft Tissue, Bone, and Joint Infections (N Safdar, Section Editor)

Prosthetic Joint Infections

Sepsis (J Russell, Section Editor)

Pediatric Sepsis: Preparing for the Future Against a Global Scourge

Sepsis (J Russell, Section Editor)

Immune Aspects of Sepsis and Hope for New Therapeutics
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits