Inexpensive rinsing effective at reducing post-op infection following joint replacement surgery

Feb 17, 2011

A rinsing technique with betadine that costs just a little over one dollar per patient may significantly reduce the infection rate following total knee and hip joint replacement surgery according to a study by researchers at Rush University Medical Center.

The study, presented at the American Association of Orthopedic Surgeons 2011 Annual Meeting, found that a three minute diluted betadine lavage combined with painting of the skin with a 10% betadine solution prior to surgical closure nearly eliminated early deep post-operative infection.

Deep periprosthetic joint infection is a rare but devastating complication associated with total . Despite aseptic techniques, careful skin preparation and , deep infections still occur with a prevalence ranging from 0.3% to 1.9%.

Previous research has shown that a diluted betadine lavage of the surgical wound prior to closure reduces the rate of post-operative infection in orthopedic, urologic, cardiovascular and general surgery but it has not been previously studied in total joint arthroplasty.

"Betadine is safe, inexpensive, simple to use, and readily available within most operating rooms," said study author Dr. Craig Della Valle, associate professor of at Rush. "In addition, betadine is effective on many types of bacteria including methicillin-resistant Staphylococcus Aureus (MRSA).

Researchers implemented a protocol for primary total knee and total hip arthroplasty in which the wound is soaked with the diluted betadine solution for three minutes following implantation of the prosthetic components. This is followed by a pulsating lavage of normal saline without antibiotics. Prior to final closure, betadine is applied to the skin surrounding the incision. Prior to this protocol, wounds were lavaged with normal saline only.

Acute post-operative deep infection was diagnosed in 18 out of the 1862 cases performed prior to the initiation of the betadine lavage protocol and in only one of the 688 total joint arthroplasties following initiation of this protocol; a reduction of the infection rate from 0.97% to 0.15%. There were no side complications associated with the treatment.

The study authors caution there are some limitations to the study. Changes in the surgeon's technique occurred over the time of the study, and it was not feasible to determine the impact of these changes on the rate of . These included variations in the incision size, suture material, and type of skin sealant.

Explore further: Vietnam battles fatal measles outbreak

add to favorites email to friend print save as pdf

Related Stories

Joint replacement: Does this look infected to you?

Sep 09, 2010

The American Academy of Orthopaedic Surgeons (AAOS) recently approved and released an evidence-based clinical practice guideline on the diagnosis of periprosthetic joint infections of the hip and knee. Clinical practice guidelines ...

Hip resurfacing is not for everyone

Nov 03, 2008

Hip resurfacing is often seen as a modern alternative to the more conventional total hip replacement, but new data from a study led by Rush University Medical Center suggest that a patient's age and gender are key to the ...

2 knee replacements may be better than 1

Feb 17, 2011

Replacing both knees in one surgery, or simultaneous total knee replacement (TKR) was associated with significantly fewer prosthetic joint infections as well as other revision knee operations within one year after surgery, ...

Race for new hips

Jun 01, 2010

A recent study by researchers at the VA Center for Health Equity Research and Promotion in Pittsburgh, Pennsylvania, suggests that patient treatment preferences play an important role in racial disparities in total joint ...

Recommended for you

US orders farms to report pig virus infections

3 hours ago

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

Foreigner dies of MERS in Saudi

3 hours ago

A foreigner has died after she contracted MERS in the Saudi capital, the health ministry said on announced Friday, bringing the nationwide death toll to 73.

Vietnam battles fatal measles outbreak

7 hours ago

Vietnam is scrambling to contain a deadly outbreak of measles that has killed more than 100 people, mostly young children, and infected thousands more this year, the government said Friday.

User comments : 0

More news stories

Suddenly health insurance is not for sale

(HealthDay)— Darlene Tucker, an independent insurance broker in Scotts Hill, Tenn., says health insurers in her area aren't selling policies year-round anymore.