Abstract
The twelve matte and twelve polished surfaces of hemi-arthroplasties were contaminated with Staph. epidermidis and then irrigated with bulb or pulse irrigation. The surfaces were then quantitatively cultured using a standardized swabbing technique. Results are expressed as the percentage of contaminant bacteria recovered. The matte finish groups showed median values of 1.46 and 2.88x10−2 while the polished finish groups showed 1.49x10−3 and 2.83x10−6 with bulb and pulse irrigation, respectively. The difference between irrigation types was significant (p=0.002) for both matte and polished surfaces. Pulse irrigation was more effective than bulb irrigation in removing contaminant bacteria from the prosthetic surfaces studied.
Tremendous suffering is associated with infection following total joint arthroplasty. To reduce infection risk, some surgeons use pulse irrigation prior to wound closure. This practice is based on the assumption that pulse irrigation will more effectively remove adherent bacteria. However, there has been no study of the effectiveness of pulse irrigation in clearing bacteria from prosthetic surfaces. The hypothesis of this study is that pulse irrigation is more effective than bulb irrigation in removing intra-operative bacterial contaminants from prosthetic surfaces.
The matte and polished surfaces of hemiarthroplasties were studied separately. Each surface was contaminated with Staph. epidermidis and then irrigated with pulse or bulb irrigation. A third group without irrigation was also studied. The surface was then swabbed three times using a standardized technique. The swab tips were quantitatively cultured.
Twelve matte and twelve polished surfaces were examined using both irrigation types with corresponding non-irrigation reference values. Results are expressed as the percentage of contaminant bacteria recovered. The matte finish groups showed median values of 1.46 and 2.88x10−2 while the polished finish groups showed 1.49x10−3 and 2.83x10−6 with bulb and pulse irrigation, respectively. The difference between irrigation types is significant (p=0.002) for both matte and polished surfaces.
Pulse irrigation was more effective than bulb irrigation in removing contaminant bacteria from the prosthetic surfaces studied.
Funding: Hip Hip Hooray, Zimmer-Sadler
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
