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Evaluation of early wound leakage as a risk factor for prosthetic joint infection

Keetie Kremers1, Borg Leijtens1, Simone Camps2

  • 1Department of Orthopedic Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.

Journal of the American Association of Nurse Practitioners
|January 26, 2019
PubMed

Insights

Prosthetic joint infections after knee or hip replacement are linked to wound leakage and hematoma. These complications increase dressing changes and hospital stays, highlighting the need for vigilant postoperative care.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Patient Safety

Background:

  • Prosthetic joint infection (PJI) is a significant complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA).
  • Identifying risk factors for PJI is crucial for improving patient outcomes and reducing healthcare burdens.

Purpose of the Study:

  • To compare patients with PJI to those with an uncomplicated postoperative course.
  • To identify specific risk factors associated with the development of PJI after TKA and THA.

Main Methods:

  • A matched case-control study design was employed.
  • Data collected included demographics, surgical characteristics, and postoperative events such as hematoma, wound leakage, and length of stay (LOS).

Main Results:

  • Patients who developed PJI experienced significantly higher rates of wound leakage (88% vs. 36%) and early wound dressing changes (88% vs. 40%).
  • Hematoma formation was more prevalent in the PJI group (44% vs. 10%).
  • A strong correlation was found between the number of wound dressing changes and PJI development (p < .001), with PJI patients having a significantly longer LOS (72% vs. 34%, OR 10.5).

Conclusions:

  • Early postoperative wound drainage and hematoma formation are direct indicators of PJI risk.
  • These factors lead to increased wound care needs and prolonged hospital stays.
  • Nurse practitioners play a vital role in early detection of adverse postoperative events, including PJI.
Abstract

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