Effect of Perioperative Bacteriological Safety on Hip Joint Infection after Hip Replacement.
BACKGROUND
In terms of clinical importance, deep infections are the most severe and problematic complications of hip replacement, and limiting the risk of these complications continues to pose a medical and organisational challenge. The aim of this retrospective study was to compare the incidence of early deep infection after hip arthroplasty in two 5-year periods separated by a long interval (1985-1989 and 2005-2009) with respect to analysing changes in the conditions of perioperative bacteriological safety.


METHODS
The records of 1408 women and 920 men who underwent the implantation of various types of hip endoprostheses were analysed. Due to changes in medical procedures over the years, two periods at a considerable interval were compared as the procedures and standards of aseptics and antiseptics in use between 1985 and 1989 differed significantly from those adhered to in 2005-2009.


RESULTS
Statistically, early deep infections after hip replacement were significantly more (15 times) common in 19851989 than in 2005-2009 (4.71% and 0.32%, respectively). Old age was a risk factor for early deep infection after hip replacement; another important issue was the manner of qualification for hip replacement surgery, with early deep infections being more common in patients after hip hemiarthroplasty performed on an emergency basis. The incidence of these complications did not depend on the patient's gender.


CONCLUSIONS
1. Emergency hip hemiarthroplasty is associated with a higher risk of deep infection. 2. Old age contributes to the development of early deep infections after hip replacement. 3. Gender does not correlate with the incidence of early post-operative deep infection after hip replacement. 4. Standardisation of aseptic (masks, caps, draping) and antiseptic (disinfectants for the equipment and hands) techniques as well as antibiotic prophylaxis decrease the risk of early deep infection after hip replacement.
Division of Anaesthesiological Nursing and Intensive Care, Medical University, Lublin, Poland.
Iwona
I
Morawik
Department of Orthopaedics and Rehabilitation, Independent Public Teaching Hospital No. 4, Lublin, Poland.
Mirosław
M
Jabłoński
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
D000900:Anti-Bacterial Agents