title: Prognostic value of suction drain tip culture in determining joint infection in primary and non-infected revision total hip arthroplasty: a prospective comparative study and review of the literature.
abstract: BACKGROUND
  Closed suction drainage in joint replacement surgery has been considered to carry an obvious risk of bacteria invasion. Previous studies have shown controversial results regarding the role of suction drain culture in predicting artificial joint infection. Furthermore, the efficacy of the method has not been established in revision total hip or knee arthroplasty.
  
  
  METHODS
  Suction drain tips from 110 patients who underwent 73 primary and 37 revision non-infected total hip arthroplasties were prospectively cultured. The drains removed at 48 h postoperatively. The patients had an average age of 64.3 years (range 25-81 years) and followed up for 2-4 years (average 2.8 years).
  
  
  RESULTS
  Positive cultures were identified in two primary (2.74%) and six revision (16.22%) total hip replacements (p = 0.017). The most frequently isolated microorganisms were Staphylococcus aureus (3 cases) and S. epidermidis (2 cases). Resistance to perioperative antibiotics was found in three out of eight isolated pathogens. However, no infection was recorded in any of the eight patients whose cultures found positive.
  
  
  CONCLUSIONS
  Although suction drains are more often contaminated in revision total hip arthroplasty, the prognostic value of the method in determining joint infection is very limited and its routine use is not supported from the clinical data.
authors.affiliation: 1st Orthopaedic Department, Aristotle University of Thessaloniki, G.Papanikolaou Hospital, Exohi, 57010, Thessaloniki, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Petsatodis
authors.forename: Marina
authors.initials: M
authors.lastname: Parziali
authors.forename: Anastasios G
authors.initials: AG
authors.lastname: Christodoulou
authors.forename: Ippokratis
authors.initials: I
authors.lastname: Hatzokos
authors.forename: Byron E
authors.initials: BE
authors.lastname: Chalidis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011379:Prognosis; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D012086:Reoperation; D013396:Suction / Q000295:instrumentation*