Abstract
Purpose of Study- To deliver high quality and high volume major joint replacement surgery through rigorous infection control and reduce both infective complications and late cancellations.
Deep infection complicating arthroplasty surgery carries a heavy fnancial and emotional burden on any orthopaedic service. The cost of hospital acquired infection is estimated at £1 billion per year 1 by the National Audit Office.
Healthcare associated infection is an area currently under great scrutiny. Each NHS trust will have an Inspector of Microbiology, who will ensure the co-ordination of information required to diagnose healthcare associated infection.
The Alexandra Hospital, Redditch has developed a dedicated elective orthopaedic ward free from multi resistant staphylococcus aureus (MRSA). that delivers high quality and high volume major joint replacement surgery through rigorous infection control.
Between October 2001 and December 2002, the Alexandra hospital had an infection rate of 0.21% for total knee replacements compared to the national rate of 2.1% p= 0.002 (CI 0.00005–0.01) The infection rate for total hip replacements was 1.31% compared to 3.8% nationwide. p = 0.01 (CI 0.004–0.03).
The total number of joint replacements performed per year increased from 256 in 2000 to 629 in 2002.
We have developed a safe, effective and efficient orthopaedic unit within the framework of an NHS trust for a relatively modest investment. We believe the practical changes that have been made within our department can be repeated in other units around the country with relative ease.
Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN
