m>Propionibacterium acnesm> (
m>P acnesm>) has been linked to chronic infections in shoulder surgery. It was recently observed during first-ti
me shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors. Because the skin biology greatly differs, we ai
med to correlate skin co
mplaints with
m>P acnesm>–positive intraoperative cultures fro
m different tissue layer sa
mples in patients undergoing shoulder surgery for the first ti
me.
Methods
Intraoperative samples (1 skin, 1 superficial, 1 deep tissue, and 1 control sample) from 112 patients (70 men, 42 women; aged 59.2 years) were cultured. The association between the presence of m>P acnesm> in the deep or superficial tissue, or both, and 10 items of a validated preoperative questionnaire for skin pathology was explored.
Results
The cultures were positive for m>P acnesm> in 38.4% (n = 43) of the cases. Skin samples were positive for m>P acnesm> in 8% (n = 9), superficial samples were positive in 23% (n = 26), and deep samples were positive in 30% (n = 34). Self-reported “loss of hair” was significantly negatively associated with the presence of m>P acnesm> in the superficial or deep tissue sample (m>Pm> = .00028).
Discussion
Patients who report having “loss of hair” show fewer m>P acnesm>–positive cultures in intraoperative tissue samples taken during open shoulder surgery. Whether this subgroup is at a lesser risk for m>P acnesm> infections remains to be substantiated.
Level of evidence
Basic Science Study; Microbiology