Subcutaneous tissue disinfection significantly reduces Cutibacterium acnes burden in primary open shoulder surgery

Moor, Beat K.; Léger, Bertrand; Steffen, Viviane; Troillet, Nicolas; Emonet, Stéphane; Gallusser, Nicolas

doi:10.1016/j.jse.2020.11.018

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…40 However, a recent prospective clinical trial underlined the importance of the additional disinfection of the subcutaneous tissue with povidone-iodine solution after skin incision as the authors demonstrated a significant reduction in contamination of the surgical field with C acnes. 38 The incapacity of systemic antibiotics to permanently eliminate C acnes, together with the additional shortcoming of creating resistant germs, 14 led to the introduction of topical agents for the treatment of acne vulgaris. BPO was introduced for its bactericidal effect on C acnes 16 through free oxygen radical mechanisms 6 by avoiding wound healing problems.…”

Section: Discussionmentioning

confidence: 99%

Acne cream reduces the deep Cutibacterium acnes tissue load before elective open shoulder surgery: a randomized controlled pilot trial

Unterfrauner

Wieser

Catanzaro

et al. 2022

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

Acne cream reduces the deep Cutibacterium acnes tissue load before elective open shoulder surgery: a randomized controlled pilot trial

Unterfrauner

Wieser

Catanzaro

et al. 2022

Journal of Shoulder and Elbow Surgery

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“…Moor et al 16 examined the benefit of subcutaneous disinfection to reduce C. acnes positive cultures in a 2:1 RCT of patients undergoing primary open deltopectoral shoulder surgery. After skin incision, the subcutaneous layer was treated with povidone-iodine solution in the disinfection group, and culture swabs were then taken from the deeper surgical field.…”

Section: Shoulder Arthroplastymentioning

confidence: 99%

What’s New in Shoulder and Elbow Surgery

Kim

Ricchetti

Hsu

2022

Journal of Bone and Joint Surgery

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Specific emphasis has been placed on higher-quality research (Level-I and II studies) and particularly relevant Level-III studies. Rotator Cuff RepairThe decision to indicate operative repair for degenerative rotator cuff tears is controversial. Kukkonen et al. 1 provided a mean 6.2-year follow-up in 150 patients who were >55 years of age; had small, full-thickness supraspinatus tears; and were randomized to physiotherapy only, acromioplasty and physiotherapy, or repair, acromioplasty, and physiotherapy. The mean change in Constant score (the primary outcome) was similar in the 3 groups, as were changes in the visual analog scale (VAS) pain and satisfaction scores. There was a significant progression of arthritis from baseline to follow-up for the entire cohort without a difference between groups. The authors suggested that operative repair is no better than conservative treatment and does not protect against degeneration of the glenohumeral joint.Long-term follow-up comparing single-row and doublerow repair techniques is uncommon. Lapner et al. 2 reported a 10-year follow-up to a previous 2-year report of a randomized controlled trial (RCT) of 90 patients comparing single-row and double-row repair. At 10 years, the Western Ontario Rotator Cuff Index (WORC) scores were higher in the double-row group. Between 2 and 10 years, significant decreases in the WORC and American Shoulder and Elbow Surgeons (ASES) scores were seen in the single-row repair group but not in the double-row repair group. Only 30 patients had 10-year ultrasound data, which demonstrated similar retear rates between groups: 23% for the single-row repair group compared with 42% for the double-row repair group (p = 0.418). The authors concluded that double-row fixation preserved joint function Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H167).

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“…Diagnosis of C. acnes infection, however, is challenging. Apart from its sometimes ambiguous clinical presentation, microbiological case definition is especially hampered by the ubiquitous presence of C. acnes , making the species also a common contaminant even of deep tissue specimens and despite appropriate skin disinfection measures ( 15 – 17 ). Moreover, recent research indicates that isolation of C. acnes even in high colony counts from prosthetic material of the shoulder does not necessarily correlate with symptomatic infection.…”

Section: Introductionmentioning

confidence: 99%