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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 82 - 82
1 Dec 2019
Hesselvig AB Odgaard A Arpi M Bjarnsholt T Madsen F
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Aim

The primary aim of this study was to examine whether the use of iodine impregnated incision drape (IIID) decreased the risk of periprosthetic joint infections (PJIs). The secondary aim was to investigate whether intraoperative contamination could predict postoperative infection.

PJI is a devastating incident for the patients and in a population that is getting older and the incidence of arthroplasty surgery is rising it is vital to keep the infection rate as low as possible. Despite prophylactic measures as pre-operative decontamination, antisepsis and prophylactic antibiotics the infection rate has been constant at 1–2%.

Method

We performed a transregional, prospective, randomized two arm study (IIID vs control group) of 1187 patients undergoing primary knee arthroplasty surgery. A database with patient demographics and surgical observations was established with the purpose of following the patients for ten years. Patients, who developed an infection within the first year of surgery were analyzed for correlation with the intraoperative bacterial findings and the use of IIID.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 248 - 248
1 Sep 2005
Stolle L Arpi M Holmberg-Jørgensen P Riegels-Nielsen P Keller J
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Objectives: Antimicrobial agents exert their effect inside the interstitial space, which is the site of many infections. Recently, microdialysis was applied to cortical and cancellous bone for the evaluation of gentamicin. The principle of microdialysis is to introduce a semipermeable membrane into bone and perfuse it with liquid, thus enabling dynamic measurements to be made.

The aim of this investigation was to measure pharmacokinetics of a Gentacoll sponge in bone tissue by microdialysis.

Materials and Methods: Nine pigs were randomized to either wet or dry application of a Gentacoll sponge (10cm* 10cm) into the bone marrow of tibia. Two catheters were inserted into cancellous bone tissue, one 1 cm (MD1cm) and one 2 cm (MD2cm) apart from the aimed location of the sponge. Then, the Gentacoll sponge was implanted. Wet application was defined as; the sponge was wetted in 2 mL. blood. Dry application was defined as usual surgical procedure. Concentrations of gentamicin were measured in serum and microdialysates on an Abbott Drug Analyser. Data presented are median (range). A rank sum test was performed for statistical analysis. A p-value below 0,05 was considered significant..AUC describes the total amount of gentamicin that passed though the tissue.

Results: The AUC6h, serum wet was 92 (72–129) and AUC6h, serum dry was 196 (142–626) mg*minute/L (P=0.02). The Cpeak, wet-group was 120 mg/L (33–585) and Cpeak, dry-group 178 mg/L(59–1294), (P=0.31). The overall (n=9) AUCMD1cm was 24431 mg*minute/L (5.155–152.855) and similar the AUCMD2cm 13759 mg*minute/L (6.351–74.573) (P=0,25). The Cpeak, MD 1cm was 106 (41–354) (P=0.21). was 209 (33–1294) and Cpeak, MD 2cm

Conclusions: This first study applied microdialysis for pharmacokinetic measurements of a local implant. The distribution of local applied antibiotics into bone tissue is difficult to measure. The small sample size precludes a detailed analysis, but previous found variation on the distribution of gentamicin from a Gentacoll sponge is reproduced in this work. It seems that neither application nor distance had impact on the initial pharmacokinetic of Gentacoll in bone tissue.