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J Knee Surg 2014; 27(04): 283-288
DOI: 10.1055/s-0034-1371771
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preoperative Skin Disinfection Methodologies for Reducing Prosthetic Joint Infections

Samik Banerjee
1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Department of Orthopaedic Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Bhaveen H. Kapadia
1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Department of Orthopaedic Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Michael A. Mont
1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Department of Orthopaedic Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

31 January 2014

03 February 2014

Publication Date:
12 March 2014 (online)

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Abstract

Surgical site infections following lower extremity total joint arthroplasty procedures remain a substantial economic burden to the patient, the treating institution, and the health care system. The complexity of these surgical procedures creates the potential for various patient- or surgery-related risk factors for infection. Although there is much literature regarding the use of many preventative methods, a consensus regarding the true efficacy and application of such practices is generally not available. In this review, we reviewed the preoperative skin disinfection methodologies that have been used for reducing periprosthetic infections following lower extremity total joint arthroplasty. Currently, cumulative evidence suggests that preoperative chlorhexidine baths or chlorhexidine-impregnated wipes may reduce the colonization of pathogenic organisms on the skin. In addition, multiple showers or topical applications of chlorhexidine may lead to more substantial reduction in colony counts. Advanced preoperative whole-body cleaning with chlorhexidine-containing cloths rather than site-specific application may confer additional advantages. Further randomized controlled trials with carefully planned protocols and endpoints are needed to determine if this conclusively leads to reduction in the rate of surgical site infections.

Keywords

surgical site infection - prevention methodologies - total joint arthroplasty
 

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