Ultraclean air and antibiotics for prevention of postoperative infection: A multicenter study of 8,052 joint replacement operations

Lidwell, O. M.; Elson, Reginald A.; Lowbury, E. J. L.; Whyte, W.; Blowers, Robert; Stanley, Susan J.; Lowe, Derek

doi:10.3109/17453678709146334

Cited by 203 publications

(93 citation statements)

References 27 publications

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“…The majority of these bacteria are removed by local wound defence mechanisms. Prophylactic antibiotics may also have a role in this bacterial clearance [10][11][12]. The presence of bacteria in the wound during the early hours following surgery may be due to their incomplete elimination and may be viewed as a high risk factor for subsequent wound infection [15].…”

Section: Introductionmentioning

confidence: 99%

Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations

Sankar

Ray

Rai

2004

International Orthopaedics (SICOT)

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We conducted a prospective cohort study in order to determine whether suction drain specimen cultures from orthopaedic surgery predicted an early wound infection. We included 218 consecutive clean orthopaedic operations requiring drains in one unit over a period of 1 year. The suction drain tip, drain fluid and wound discharge specimens were cultured, and the surgical wound was followed up for 3 months. There were six deep and two superficial wound infections. Wound infection was significantly related to positive suction tip culture but not to positive drain fluid culture. Following our methodology for culture, a positive drain tip culture predicts wound infection in 50% and a negative culture virtually excludes the possibility of a deep infection.Résumé Nous avons conduit prospectivement une étude de cohorte pour déterminer si les cultures d'un échantillon du produit de drainage aspiratif peuvent être prédictives précocément d'une infection. Nous avons inclus 218 opérations orthopédiques propres consécutives, exigeant un drainage, sur une période d'une année. L'extrémité du drain, le liquide de drainage, et des prélévements opératoires étaient mis en culture et la cicatrice chirurgicale surveillée pendant 3 mois. Il y avaient 2 infections superficielles et 6 pronfondes. L'infection était en rapport significatif avec la culture du drain mais sans rapport avec celle du liquide de drainage. En suivant notre méthodo-logie, une culture positive de l'extrémité du drain prédit l'infection de la blessure dans 50% et une culture négative exclut la possibilité d'une infection profonde.

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Section: Introductionmentioning

confidence: 99%

Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations

Sankar

Ray

Rai

2004

International Orthopaedics (SICOT)

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“…44,58 In general, current rates of deep infection are estimated around 1 % and between 1 % and 2 % for primary hip and knee arthroplasties, respectively. 20,29,41,63,65 The incidence of infection following a revision hip arthroplasty has been reported to range between 2 and 6 %. 20,29 Some investigators have suggested that the real number of deep sepsis is higher.…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of Prosthesis-Related Infection

Gallo¹,

Kolář²,

R³

et al. 2003

BIOMED PAP

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In spite of its incidence decreasing to 1% nowadays, prosthesis-related infection remains a research, diagnostic, therapeutic and cost-related problem. It can be defined as a presence of bacteria in the artificial joint space, which is significantly associated with evident laboratory and/or tissue markers, and clinical signs of running infection. We believe that the more precise understanding of pathogenesis, the more effective preventative and therapeutic measures, and the lower infection rate. The implants are colonized by airborne, skin-, and/ or surgeon-related bacteria during surgery despite being operated in closely respected operating regime. Some prosthetic characteristics are advantageous and may play important roles in the process of bacterial adherence. After successful attachment on the biomaterial surface bacteria multiply and physiologically transform into a "biofilm" community, making them much more resistant to antibiotic therapy and host immunity. Bacterial resistance is a complex phenomenon influenced by intrinsic and extrinsic factors, including the cell configuration in the biofilm community. So the cure of periprosthetic sepsis without removing of all foreign bodies and necrotic bone fragments is often ineffective. Acute hematogenous sepsis is suggestive of a distortion of a previously aseptic joint space by invasion of bacteria through the vessels.operative cultures in the group of 29 preoperatively "aseptic" cases. 57

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“…Laminar airflow ventilation systems provide vertical layers of air movement in the operating room such that the flow is highest directly over the surgical site, limiting the introduction of particles from the environment and personnel. Lidwell et al (1987) demonstrated a significant reduction in the rate of surgical site infections in veterinary hospitals after the introduction of laminar airflow systems.…”

Section: Simulation and Measurement Of Air Movement Inside A Standardmentioning

confidence: 99%

Simulation and Measurement of Air Movement Inside a Standard Veterinary Operating Room Produced by a Double-Equal Strength Diffuser

Domniţa¹,

Fetea²,

Ilutiu-Varvara³

et al. 2016

BUASVMCN-VM

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The main purpose of air diffusers is to achieve ventilation effect by obtaining a proper distribution of the introduced air jet. Even more in the case of veterinary operating rooms, it is necessary to use air diffusers that allow the introduction of large volumes of air without exceeding admissible indoor air velocities in the occupied zone.The paper presents a device with double-equal strength diffuser for introducing conditioned air inside a standard veterinary operating. There are presented the measurements that were performed in order to establish the air velocity field generated by the diffuser. It is also shown the computational air movement simulation produced by this device in two models of veterinary operating room.The diffuser allows the distribution of large quantities of blow-in air with low velocities, recommended for using in locations with a high required air exchange. The simulations provides an overview of velocity and pressure fields generated by the double-equal strength diffuser for spatial distribution of air, within two sitemodels of veterinary operating room. Simulation results are displayed graphically by presenting the distribution of air velocity vectors in different planes of intersection with the considered site-model configuration.Analyzing the results of simulations performed on the two models, together with the measurements made in the laboratory on the double exponential profile diffuser, it can be concluded that the device provides good solutions in terms of air flow inside the operating room. Thus, is obtained a hybrid airflow cleanroom, recommended in recent years in scientific literature to use in veterinary operating rooms.

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Ultraclean air and antibiotics for prevention of postoperative infection: A multicenter study of 8,052 joint replacement operations

Abstract: (1987) Ultraclean air and antibiotics for prevention of postoperative infection: A multicenter study of 8,052 joint replacement operations, Acta Orthopaedica Scandinavica, 58:1, 4-13,

Cited by 203 publications

References 27 publications

Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations

Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations

Pathogenesis of Prosthesis-Related Infection

Simulation and Measurement of Air Movement Inside a Standard Veterinary Operating Room Produced by a Double-Equal Strength Diffuser

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