A systematic review and meta-analysis comparing intrawound vancomycin powder and povidone iodine lavage in the prevention of periprosthetic joint infection of hip and knee arthroplasties

Martin, Vidmi Taolam; Yan, Zhang; Wang, Zhaozhen; Liu, Qiaolan; Yu, Bo

doi:10.1016/j.jos.2022.11.013

Cited by 10 publications

(21 citation statements)

References 24 publications

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“…A total of four studies were reported on PJI 17,18,20,22 . Among them, Martin et al, 22 including primary and revision arthroplasty, eliminated the revision cases, recalculated the results to obtain the OR, and then combined them with other results.…”

Section: Resultsmentioning

confidence: 99%

The application of topical antibiotics for the prevention of infections in primary joint arthroplasty. An umbrella review of systematic reviews and meta‐analysis

Luo,

Chen,

Pan

et al. 2024

International Wound Journal

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This umbrella review aim to explore the effect of topical antibiotics in infection prevention after primary joint arthroplasty, and provide a specific theoretical basis for clinical treatment. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. We searched PubMed, EMBASE, Medline, and the Cochrane Library on infection prevention by topical antibiotics from inception to 10 April 2023. The two researchers individually and strictly screened the literature according to the inclusion and exclusion criteria, performed the literature quality evaluation and data extraction, and used Stata 17 for data analysis. This study included six studies with one systematic review and five meta‐analyses. The pooled analysis showed that topical antibiotic administration effectively reduced the incidence of overall infection and periprosthetic joint infection. However, it does not reduce the risk of superficial infection. Besides, the topic of antibiotics significantly increases the incidence of other sterile complications of the incision. According to the current evidence, topical application of antibiotics can reduce the incidence of overall infection and periprosthetic joint infection after primary joint arthroplasty. Although it increases the incidence of complications such as delayed healing of incisions, the pros and cons should be weighed in clinical decision making. However, they should not be discarded due to side effects.

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Section: Resultsmentioning

confidence: 99%

The application of topical antibiotics for the prevention of infections in primary joint arthroplasty. An umbrella review of systematic reviews and meta‐analysis

Luo,

Chen,

Pan

et al. 2024

International Wound Journal

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“…Another basic science study found that povidone-iodine, sodium hypochlorite, and acetic acid-based irrigants all demonstrated eradication of all bacterial growth in <2 minutes of contact 9 . Five of 7 trials in a recent systematic review and meta-analysis found a benefit in reducing PJI rates with the use of topical vancomycin powder and povidone-iodine solution, but the studies were of poorer quality with varying dosing and also found higher rates of wound complications in those patients receiving vancomycin powder alone 10 . A systematic review and meta-analysis published last year specifically on the use of vancomycin powder did find a reduction in PJI rates; however, the quality of those studies were poor as well 11 .…”

Section: Preventionmentioning

confidence: 99%

What’s New in Musculoskeletal Infection

Otero

Brown

Courtney

et al. 2023

Journal of Bone and Joint Surgery

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“…The ideal irrigation solution should not only have a good sterilization effect but also have the characteristics of low concentration, good stability, low irritation, low cost, safety, and so on ( Chen et al, 2021 ). Various irrigation solutions are currently being used, for example, sterile saline solution was the most frequently used fluid ( Trevillion, 2008 ), followed by povidone-iodine ( Martin et al, 2022 ), chlorhexidine ( Willigenburg et al, 2023 ), hydrogen peroxide ( Mohammadi et al, 2013 ), and antibiotic solutions ( Siafaka et al, 2016 ; Ameeduzzafar et al, 2018 ). However, considering that the antibacterial properties of these irrigation solutions were mostly evaluated using Escherichia coli and Staphylococcus aureus ( Zhou et al, 2017 ; Aubert-Viard et al, 2019 ), which was different from the microbiota composition of the seawater immersion wound, common medical irrigations have little effect when the affected area is immersed in seawater, and rarely, irrigations have been reported for the treatment of seawater-immersed wounds.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial efficacy of composite irrigation solution against dominant pathogens in seawater immersion wound and in vivo wound healing assessment

Wang

Tan

et al. 2023

Front. Microbiol.

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Seawater immersion wound is inevitably accompanied by bacterial infection. Effective irrigation is critical for bacterial infection prevention and wound healing. In this study, the antimicrobial efficacy of a designed composite irrigation solution against several dominant pathogens in seawater immersion wounds was evaluated, and in vivo wound healing assessment was conducted in a rat model. According to the time–kill result, the composite irrigation solution exhibits excellent and rapid bactericidal effect against Vibrio alginolyticus and Vibrio parahaemolyticus within 30 s of treatment while eliminating Candida albicans, Pseudomonas aeruginosa, Escherichia coli, and the mixed microbes after 1 h, 2 h, 6 h, and 12 h of treatment, respectively. Significant bacterial count reduction of Staphylococcus aureus was observed after 5 h treatment. In addition to its skin non-irritating attribute, the in vivo wound healing results further demonstrated that the irrigation solution showed high repair efficiency in the skin defect model inoculated with the mixed microbes. The wound healing rate was significantly higher than that of the control and normal saline groups. It could also effectively reduce the number of viable bacteria on the wound surface. The histological staining indicated that the irrigation solution could reduce inflammatory cells and promote collagen fibers and angiogenesis, thereby promoting wound healing. We believed that the designed composite irrigation solution has great potential for application in the treatment of seawater immersion wounds.

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A systematic review and meta-analysis comparing intrawound vancomycin powder and povidone iodine lavage in the prevention of periprosthetic joint infection of hip and knee arthroplasties

Cited by 10 publications

References 24 publications

The application of topical antibiotics for the prevention of infections in primary joint arthroplasty. An umbrella review of systematic reviews and meta‐analysis

The application of topical antibiotics for the prevention of infections in primary joint arthroplasty. An umbrella review of systematic reviews and meta‐analysis

What’s New in Musculoskeletal Infection

Antimicrobial efficacy of composite irrigation solution against dominant pathogens in seawater immersion wound and in vivo wound healing assessment

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