title: Preoperative chlorhexidine preparation and the incidence of surgical site infections after hip arthroplasty.
abstract: The purpose of this study was to evaluate effectiveness of an advance, at-home chlorhexidine-impregnated skin preparation cloth in decreasing the incidence of deep periprosthetic hip arthroplasty infections. Arthroplasty surgeons at the senior author's institution provided their patients with chlorhexidine-impregnated single-use cloths for use at home the night before and the morning of surgery. Between January 2007 and December 2009, the compliance of this practice, as well as the incidence of periprosthetic infections, was monitored for all patients who underwent hip arthroplasty. Of the 1134 patients who underwent hip arthroplasty, 157 patients completely complied with the preoperative chlorhexidine preparation protocol. There were 14 infections in the group that was not compliant (1.6% infection rate), and there were no infections in the compliant patient population. Based on the results of this study, at-home preoperative patient skin preparation appears to be a simple and cost-effective method to reduce periprosthetic hip infection rates.
authors.affiliation: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland 21215, USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Daley
authors.forename: Michael G
authors.initials: MG
authors.lastname: Zywiel
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Delanois
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D002710:Chlorhexidine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006622:Hip Prosthesis / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine