Infection rate in total hip arthroplasty as a function of air cleanliness and antibiotic prophylaxis. 10-year experience with 2,384 cementless Lord madreporic prostheses.
To separate the respective effects of sterile air and antibiotic prophylaxis in orthopedic surgery, the authors reviewed 2,384 cementless total hip replacements performed from 1975 to 1984 for incidence of deep sepsis. During this period, a conventionally ventilated room (100 particle-forming units (pfu)/m3) and a laminar vertical flow (1 pfu/m3) were alternately used, without significant difference in the sepsis rate. Beginning in 1979, a prophylactic antibiotic regimen was added, which from 1979 to 1984 reduced the incidence of deep sepsis from 2.78% to 0.52%. There was also a change in common infecting organisms, from sensitive to resistant strains, which is not an insignificant consequence.
D000391:Air Microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002435:Cefamandole / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005839:Gentamicins / Q000627:therapeutic use; D006622:Hip Prosthesis; D006801:Humans; D011292:Premedication; D012306:Risk; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002435:Cefamandole; D002437:Cefazolin; D002512:Cephalothin