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Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
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Prophylactic peri-operative local antibiotic irrigation.

L A Whiteside1

  • 1Missouri Bone and Joint Research Foundation, 1000 Des Peres Rd, Suite 150, St. Louis, MO 63131, USA.

The Bone & Joint Journal
|January 7, 2016
PubMed
Summary

Local antibiotic irrigation effectively prevents acute post-operative infections in total joint arthroplasty. This surgical protocol demonstrated high efficacy with minimal complications in a large retrospective study.

Keywords:
arthroplastybactericidalinfectionlocal antibiotic irrigationprophylaxis

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Prevention
  • Surgical Site Infection Control

Background:

  • Post-operative infections are a significant complication in total joint arthroplasty.
  • Preventative strategies are crucial to minimize patient morbidity and healthcare costs.

Purpose of the Study:

  • To evaluate the effectiveness of local antibiotic irrigation in preventing acute post-operative infections after total joint arthroplasty.
  • To assess the safety and complication rates associated with this intra-operative protocol.

Main Methods:

  • Retrospective analysis of 2293 total joint arthroplasties performed between January 2004 and December 2013.
  • Intra-operative protocol included normal saline with vancomycin and polymyxin irrigation.
  • Mean follow-up period of 73 months.

Main Results:

  • Minimal post-operative infection rates observed across all procedures.
  • No patients required re-admission for primary infection or further antibiotic treatment.
  • Two cases of subcutaneous fat necrosis and one secondary deep infection requiring revision were noted.

Conclusions:

  • Local antibiotic irrigation during arthroplasty surgery is highly effective in preventing infection.
  • Judicious use of antibiotics is essential to prevent the development of resistant organisms.
  • Antibiotic stewardship remains a critical component of surgical practice.