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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Use of a chlorhexidine-impregnated patch does not decrease the incidence of bacterial colonization of femoral nerve
Kristopher M Schroeder1, Robert A Jacobs, Christopher Guite
1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, B6/319 CSC, Madison, WI 53792, USA. kmschro1@wisc.edu
Summary
The BIOPATCH chlorhexidine-impregnated patch did not reduce bacterial colonization rates for femoral nerve catheters (FNCs) in total knee arthroplasty patients. Standard sterile techniques and antibiotic use resulted in low baseline colonization.
Area of Science:
- Medical Microbiology
- Infectious Disease Prevention
- Surgical Site Infections
Background:
- Femoral nerve catheters (FNCs) are crucial for postoperative pain management after total knee arthroplasty (TKA).
- Bacterial colonization of FNCs is a known complication, with varying reported rates.
- The BIOPATCH, a chlorhexidine-impregnated dressing, is designed to reduce bacterial growth and has shown efficacy with other catheter types.
Purpose of the Study:
- To evaluate the effectiveness of the BIOPATCH in decreasing bacterial colonization rates of FNCs.
- To determine if BIOPATCH application reduces FNC tip or exit site bacterial growth in TKA patients.
Main Methods:
- A prospective study of 100 TKA patients, excluding those at high infection risk.
- Patients received FNC insertion using sterile, ultrasound-guided techniques with chlorhexidine skin cleansing.
- Participants were randomized to receive either BIOPATCH application or no patch at the catheter exit site.
Main Results:
- No significant difference in catheter tip colonization between BIOPATCH (6.3%) and non-BIOPATCH (4.3%) groups.
- No significant difference in catheter exit site colonization between BIOPATCH (12/48) and non-BIOPATCH (14/47) groups.
- A trend towards increased local skin inflammation and polymicrobial colonization at the exit site in the non-BIOPATCH group.
Conclusions:
- The combination of short-term use, chlorhexidine decontamination, ultrasound guidance, tunneling, and antibiotics results in a low baseline rate of FNC bacterial colonization.
- BIOPATCH did not demonstrate a significant benefit in reducing bacterial colonization for FNCs in this TKA patient population.
- Further research may explore specific patient subgroups or alternative antimicrobial strategies.
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