Surgical Site Infection After Total Knee Arthroplasty : A Descriptive Study
Abstract
Joint replacement operations which are applied to reduce the pain and increase the movement capacity are among the surgical procedures that are used mostly nowadays. Even though a dramatic recovery is seen in the life of the patient after total knee prosthesis, possible prosthesis infection increases cost and causes high morbidity. This study was conducted with the aim to determine rates of surgical site infection after performing primer total knee prothesis operation in our clinic. Furthermore, it has been intended to understand risk factors which may cause infection and then take precautions. This study was conducted from January 2008 to January 2013, 252 knees underwent primary total knee arthroplasty operations. Among these patients infection rates, relationship to risk factors and infection treatments were analysed. It was observed that iIn 252 knees, 10 (4%) superficial infections were found, debridement and antibiotics were applied to 3 knees out of 10 and only antibiotic treatment was applied to the rest 7 knees. Deep infection was detected in 4 knees (1,6%) out of 252. Acute deep infection in 1 knee and recovery was provided with debridement and intravenous antibiotics treatment. Late deep infection was not detected in any of patients. Delayed deep infection was detected in 3 (1,1%) of these knees though. Among all risk factors only increased body mass index showed increased superficial wound infection rate. It can be concluded that among the factors like rheumatoid arthritis, diabetes, age, gender, body mass index, just body mass index has an impact on superficial infection rate. Our infection rates were comparable to rates mentioned in universal literature for primary total knee replacement operations.
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Introduction
With the aging population, joint diseases are seen more often today. Pain and limitation of movement ability in these diseases occur and with joint injury over time decrease life quality of the patients considerably. Therefore, joint replacement operations which are applied to reduce the pain and increase the movement capacity are among the surgical procedures that are used mostly now a day. Even though a dramatic recovery is seen in the life of the patient after total knee prosthesis, possible prosthesis infection increases cost and causes high morbidity. According to the research applied in a number of different centers, 0,5%-5% infection rates have been reported after primer total knee arthroplasty. 1,2.3
Infection mechanism takes place through direct transmission of disease or haematogenous. Some examples of direct transmission are unclean operating theatres, transmission from an infected patient, usage of torn surgical gloves, negligence of the operating staff about sterility and these cases can be taken under control. Transmission through haematogenous occurs following bacteremia.
Conclusion
Primary total knee arthroplasty infection rates can be kept low when necessary preoperative, intraoperative and postoperative infection precautions are taken into account. It is found that among the factors like rheumatoid arthritis, diabetes, age, gender, body mass index, just body mass index has an impact on superficial infection rate. This means that when body mass index increases, superficial infection rate also increases. Our infection rates were comparable to rates mentioned in universal literature for primary total knee replacement operations.