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Orthopedic infection control

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https://www.readbyqxmd.com/read/28532076/sustained-drug-release-from-surface-modified-uhmwpe-for-acetabular-cup-lining-in-total-hip-implant
#1
R Manoj Kumar, Pallavi Gupta, Sandan Kumar Sharma, Akshat Mittal, Manish Shekhar, Vijayesh Kumar, B V Manoj Kumar, Partha Roy, Debrupa Lahiri
Despite sterilization and aseptic procedure, bacterial infection remains a key challenge in total hip arthroplasties. This fact emphasizes the urgent need for development of new implant systems, which should releases the drug in a controlled manner without sparing its mechanical and tribological properties. In this study, the lining material of the acetabular cup, in total hip implant, has been modified for sustained release of drugs, which should be available throughout the site of implantation to fight the post-operation bacterial infection...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28487001/effect-of-medicare-s-nonpayment-policy-on-surgical-site-infections-following-orthopedic-procedures
#2
Jereen Z Kwong, Yingjie Weng, Micaela Finnegan, Robyn Schaffer, Austin Remington, Catherine Curtin, Kathryn M McDonald, Jay Bhattacharya, Tina Hernandez-Boussard
OBJECTIVE Orthopedic procedures are an important focus in efforts to reduce surgical site infections (SSIs). In 2008, the Centers for Medicare and Medicaid (CMS) stopped reimbursements for additional charges associated with serious hospital-acquired conditions, including SSI following certain orthopedic procedures. We aimed to evaluate the CMS policy's effect on rates of targeted orthopedic SSIs among the Medicare population. DESIGN We examined SSI rates following orthopedic procedures among the Medicare population before and after policy implementation compared to a similarly aged control group...
May 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28448706/-prognostic-factors-for-post-surgical-complications-in-bone-infection-and-pseudarthrosis
#3
A Cicero-Álvarez, S R León-Hernández, K Gutiérrez-Enríquez, S Zapata-Rivera
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28448204/future-research-opportunities-in-peri-prosthetic-joint-infection-prevention
#4
Elie Berbari, John Segreti, Javad Parvizi, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty...
April 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28434696/complete-eradication-of-biofilm-from-orthopedic-materials
#5
Jeffrey T Leary, Matthew M Werger, William H Broach, Lindsey N Shaw, Brandon G Santoni, Thomas L Bernasek, Steven T Lyons
BACKGROUND: Interest exists in finding alternatives to current management strategies in periprosthetic joint infections, which typically include a 2-stage revision with placement of an antibiotic spacer and delayed placement of a new implant. We studied the efficacy of autoclaving, ultrasonication, and mechanical scrubbing for sterilization and biofilm eradication on infected cobalt-chrome discs. METHODS: Strains of Staphylococcus aureus MRSA252 or Staphylococcus epidermidis RP62A were grown on the discs...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#6
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28396930/initial-management-of-complex-hand-injuries-in-military-or-austere-environments-how-to-defer-and-prepare-for-definitive-repair
#7
Camille Choufani, Olivier Barbier, Antoine Grosset, James Charles Murison, Didier Ollat, Sylvain Rigal, Laurent Mathieu
INTRODUCTION: The damage control orthopedics (DCO) concept is a sequential surgical management strategy indicated when ideal primary treatment is not possible or suitable. DCO principles are routinely applied to hand traumas in wartime practice, but could also be useful in a civilian setting when immediate specialized management cannot be carried out. METHODS: The authors report three typical observations of soldiers treated for a complex hand trauma on the field by orthopedic surgeons from the French Military Health Service (FMHS)...
April 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28372660/airborne-bacterial-contamination-during-orthopedic-surgery-a-randomized-controlled-pilot-trial
#8
Ruken Oguz, Magda Diab-Elschahawi, Jutta Berger, Nicole Auer, Astrid Chiari, Ojan Assadian, Oliver Kimberger
STUDY OBJECTIVE: Several factors such as lack of unidirectional, turbulent free laminar airflow, duration of surgery, patient warming system, or the number of health professionals in the OR have been shown or suspected to increase the number of airborne bacteria. The objective of this study was to perform a multivariate analysis of bacterial counts in the OR in patients during minor orthopedic surgery. DESIGN: Prospective, randomized pilot study. SETTING: Medical University of Vienna, Austria...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28358974/the-impact-of-lumbar-spine-disease-and-deformity-on-total-hip-arthroplasty-outcomes
#9
Daniel J Blizzard, Charles Z Sheets, Thorsten M Seyler, Colin T Penrose, Mitchell R Klement, Michael A Gallizzi, Christopher R Brown
Concomitant spine and hip disease in patients undergoing total hip arthroplasty (THA) presents a management challenge. Degenerative lumbar spine conditions are known to decrease lumbar lordosis and limit lumbar flexion and extension, leading to altered pelvic mechanics and increased demand for hip motion. In this study, the effect of lumbar spine disease on complications after primary THA was assessed. The Medicare database was searched from 2005 to 2012 using International Classification of Diseases, Ninth Revision, procedure codes for primary THA and diagnosis codes for preoperative diagnoses of lumbosacral spondylosis, lumbar disk herniation, acquired spondylolisthesis, and degenerative disk disease...
May 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28288878/outcomes-and-complications-of-percutaneous-versus-open-repair-of-acute-achilles-tendon-rupture-a-meta-analysis
#10
REVIEW
Bo Yang, Yang Liu, Shunli Kan, Di Zhang, Hong Xu, Feifei Liu, Guangzhi Ning, Shiqing Feng
BACKGROUND: Acute Achilles tendon rupture (AATR) is a frequent injury occurring dominantly in young to middle-aged males. Outcomes and complications between percutaneous and open repair are still controversial. Thus, the purpose of this meta-analysis is to evaluate the outcomes and complications of these two operative methods. MATERIALS AND METHODS: We searched multiple databases: PubMed, Web of Science, EMBASE and the Cochrane Library up to October 2016. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted data from eligible studies, with confirmation by cross-checking...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28274617/predictive-model-of-surgical-time-for-revision-total-hip-arthroplasty
#11
Albert Wu, Michael J Weaver, Marilyn M Heng, Richard D Urman
BACKGROUND: Maximizing operating room utilization in orthopedic and other surgeries relies on accurate estimates of surgical control time (SCT). A variety of case and patient-specific variables can influence the duration of surgical time during revision total hip arthroplasty (THA). We hypothesized that these variables are better predictors of actual SCT (aSCT) than a surgeon's own prediction (pSCT). METHODS: All revision THAs from October 2008 to September 2014 from one institution were accessed...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28245906/definition-of-infection-after-fracture-fixation-a-systematic-review-of-randomized-controlled-trials-to-evaluate-current-practice
#12
REVIEW
W J Metsemakers, K Kortram, M Morgenstern, T F Moriarty, I Meex, R Kuehl, S Nijs, R G Richards, M Raschke, O Borens, S L Kates, C Zalavras, P V Giannoudis, M H J Verhofstad
INTRODUCTION: One of the most challenging musculoskeletal complications in modern trauma surgery is infection after fracture fixation (IAFF). Although infections are clinically obvious in many cases, a clear definition of the term IAFF is crucial, not only for the evaluation of published research data but also for the establishment of uniform treatment concepts. The aim of this systematic review was to identify the definitions used in the scientific literature to describe infectious complications after internal fixation of fractures...
February 20, 2017: Injury
https://www.readbyqxmd.com/read/28244328/facile-preparation-of-poly-lactic-acid-brushite-bilayer-coating-on-biodegradable-magnesium-alloys-with-multiple-functionalities-for-orthopedic-application
#13
Lei Zhang, Jia Pei, Haodong Wang, Yongjuan Shi, Jialin Niu, Feng Yuan, Hua Huang, Hua Zhang, Guangyin Yuan
Recently magnesium and its alloys have been proposed as a promising next generation orthopedic implant material, whereas the poor corrosion behavior, potential cytotoxicity, and the lack of efficient drug delivery system have limited its further clinical application, especially for the local treatment of infections or musculoskeletal disorders and diseases. In this study, we designed and developed a multifunctional bilayer composite coating of poly(lactic acid)/brushite with high interfacial bonding strength on a Mg-Nd-Zn-Zr alloy, aiming to improve the biocorrosion resistance and biocompatibility of the magnesium-based substrate, as well as to further incorporate the biofunctionality of localized drug delivery...
March 22, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28240815/antimicrobial-and-immunomodulatory-surface-functionalized-electrospun-membranes-for-bone-regeneration
#14
Asha Mathew, Cedryck Vaquette, Saeed Hashimi, Irani Rathnayake, Flavia Huygens, Dietmar W Hutmacher, Saso Ivanovski
Guided bone regeneration (GBR) is a surgical procedure utilizing occlusive membranes for providing space maintenance and enabling selective repopulation of the damaged area. While this technique is effective in regenerating bone, bacterial infiltration occurs frequently and can compromise the regenerative outcome. In this study, the authors describe the development and characterization of a GBR membrane made of medical grade polycaprolactone (mPCL) electrospun fibers with antibacterial and immunomodulatory properties...
February 27, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28166064/incidence-and-risk-factors-of-surgical-site-infections-in-kathmandu-university-hospital-kavre-nepal
#15
S Shrestha, P Wenju, R Shrestha, R M Karmacharya
Background Surgical site infections (SSI) are the common nosocomial infection in surgical patients, and are a significant source of postoperative morbidity resulting in increased hospital stay, morbidity and cost. Objective The objective of this study was to obtain the incidence of SSI and determine various risks factors influencing the SSI rate with special reference to the National Nosocomial Infections Surveillance System risk index in Kathmandu University Hospital, Kavre, Nepal. Method Six hundred and thirty eight patients who underwent various surgeries in Dhulikhel Hospital, Kathmandu University Hospital during a three-month period were included...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28155060/fast-resorbable-antibiotic-loaded-hydrogel-coating-to-reduce-post-surgical-infection-after-internal-osteosynthesis-a-multicenter-randomized-controlled-trial
#16
Kostantinos Malizos, Michael Blauth, Adrian Danita, Nicola Capuano, Riccardo Mezzoprete, Nicola Logoluso, Lorenzo Drago, Carlo Luca Romanò
BACKGROUND: Infection is one of the main reasons for failure of orthopedic implants. Antibacterial coatings may prevent bacterial adhesion and biofilm formation, according to various preclinical studies. The aim of the present study is to report the first clinical trial on an antibiotic-loaded fast-resorbable hydrogel coating (Defensive Antibacterial Coating, DAC(®)) to prevent surgical site infection, in patients undergoing internal osteosynthesis for closed fractures. MATERIALS AND METHODS: In this multicenter randomized controlled prospective study, a total of 256 patients in five European orthopedic centers who were scheduled to receive osteosynthesis for a closed fracture, were randomly assigned to receive antibiotic-loaded DAC or to a control group (without coating)...
February 2, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28137325/interhospital-comparison-of-surgical-site-infection-rates-in-orthopedic-surgery
#17
Jozica Skufca, Jukka Ollgren, Mikko J Virtanen, Kaisa Huotari, Outi Lyytikäinen
OBJECTIVE To investigate whether comparison by deep or adjusted deep surgical site infection (SSI) rates in orthopedic surgeries are a better basis for feedback to Finnish hospitals than overall SSI rates DESIGN Retrospective cohort study SETTING Hospitals conducting surveillance of hip arthroplasties (HPROs) and knee arthroplasties (KPROs) in the Finnish Hospital Infection Program METHODS We analyzed surveillance data for 73,227 HPROs and 56,860 KPROs performed in 18 hospitals during 1999-2014. For each hospital, the overall, deep, and adjusted deep SSI rates with 95% confidence intervals (CIs) were calculated, and the hospital ranks were simulated in the Bayesian framework...
January 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28123296/reduced-bacterial-growth-and-increased-osteoblast-proliferation-on-titanium-with-a-nanophase-tio2-surface-treatment
#18
Garima Bhardwaj, Thomas J Webster
BACKGROUND: The attachment and initial growth of bacteria on an implant surface dictates the progression of infection. Treatment often requires aggressive antibiotic use, which does not always work. To overcome the difficulties faced in systemic and local antibiotic delivery, scientists have forayed into using alternative techniques, which includes implant surface modifications that prevent initial bacterial adhesion, foreign body formation, and may offer a controlled inflammatory response...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28122513/drug-resistance-dynamics-of-staphylococcus-aureus-between-2008-and-2014-at-a-tertiary-teaching-hospital-jiangxi-province-china
#19
Kaisen Chen, Yanfang Huang, Qiuyue Song, Chenhui Wu, Xiaowen Chen, Lingbing Zeng
BACKGROUND: To understand the relationship between the Staphylococcus aureus infection rate and the reasonable usage of antibiotics, which will help in the effective control of MRSA infection. METHODS: All data were obtained by the application of the nosocomial infection surveillance network. Drug resistance, departmental sources, and isolated sites as well as infection rate variations of S. aureus were analyzed in the 7-year period in key departments. RESULTS: Between 2008 and 2014, 2525 strains of S...
January 25, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28069094/a-practical-tool-for-surveillance-of-surgical-site-infections-a-5-year-experience-in-orthopedic-surgeries
#20
Shmuel Benenson, Allon E Moses, Matan J Cohen, Meir Brezis, Naomi Minster, Carmela Schwartz, Leonid Kandel, Meir Liebergall, Yoav Mattan
Continuous surveillance of surgical-site infection (SSI) is labor intensive. We developed a semiautomatic surveillance system partly assisted by surgeons. Most patients who developed postdischarge SSI were readmitted, which allowed us to limit postdischarge surveillance to this group. This procedure significantly reduced workload while maintaining high sensitivity and specificity for SSI diagnosis. Infect Control Hosp Epidemiol 2017;38:610-613.
May 2017: Infection Control and Hospital Epidemiology
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