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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 29 - 29
1 Dec 2016
Parker S Davies L Sanders-Crook L Key T Roberts G Hughes H White S
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Aim

Peri-prosthetic joint infection is a serious and expensive complication of joint arthroplasty. Theatre discipline has infection prevention at its core with multiple studies correlating increased door opening with surgical site infection. The WHO, NICE and Philadelphia Consensus all advocate minimal theatre traffic. The Dutch Health Inspectorate consider >5 door openings per procedure excessive.

Method

This prospective observational study over five weeks observed theatre door traffic during hip and knee arthroplasty within the eight laminar flow theatres at our institution. Two students attached to the department collected data. Half way through the study notices reminding people not to enter during arthroplasty were placed on the theatre doors.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 45 - 45
1 Dec 2016
Parker S Key T Hughes H White S
Full Access

Aim

The majority of peri-prosthetic joint infection occurring within 1 year of surgery is due to introduction of microbes at the time of surgery. Lavage of total knee replacement leaves a pool of fluid on the surgical drapes. This fluid could be a direct source of wound contamination via suction catheter tip, gloves or instruments.

Method

Twenty patients undergoing total knee arthroplasty had a sample of drape fluid sent, after prosthesis implantation, for standard and enrichment culture. The surgery took place in a laminar low theatre with scrub teams in togas* and drapes**. Normal saline was used as the wash. 20ml fluid was taken via syringe and transferred to blood culture bottles in theatre post-operatively.