Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter?

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• 作者：Anthony L. Yu ; MD ; David C. Alfieri ; MD ; Kristen N. Bartucci ; MA ; Adam M. Holzmeister ; BS ; Harold W. Rees ; MD
• 关键词：primary knee arthroplasty ; perioperative protocols ; incision care ; showering ; TKA
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：31
• 期：10
• 页码：2256-2259
• 全文大小：193 K

文摘

Current literature is limited with regard to standardized postoperative surgical site hygiene after total knee arthroplasty (TKA). With little guidance from the literature, the timing of permissible postoperative cleaning is a decision made by the individual surgeon using anecdotal evidence. A standardized wound care regimen is of particular interest to minimize the risk of infection.

Methods

To examine what species of bacteria recolonize the surgical site postoperatively, a randomized controlled trial was performed of 16 TKA patients who were allowed to shower at 2 days postoperatively and of 16 patients who were asked to wait until 2 weeks postoperatively before showering after TKA. Culture swabs of skin adjacent to the incision were performed preoperatively, just after incision closure, at dressing removal, and at 2 weeks postoperatively. Bacteria were speciated and compared between groups. A swab of the contralateral knee was performed at 2 weeks as a control. A survey of patient's preference regarding early and late showering was also carried out.

Results

No difference was found between the groups in rate of colonization or bacterial type, and no patients developed infection. Patients overwhelmingly preferred early showering rather than late (P = .28-.99).

Conclusion

There is no difference in surgical site bacterial recolonization between early and delayed showering after primary TKA.