Normeditec

Prevention of periprosthetic infections

The majority of infections after knee and hip arthroplasty are only detected after being discharged from hospital. Data from Switzerland (Staszewicz et al. 2014, Troillet et al. 2017) [22, 23] shows that around 80% of wound infections in the case of hip prostheses and around 95% in the case of knee prostheses do not become evident until after discharge. That means that if only the knee prosthesis infection rate is recorded in-house, it can be assumed that the real infection rate is at least 80 % higher.

Assumption: the bacteria do not primarily enter the wound via the air, but via the contaminated instruments!

Would you be ready to open a prosthesis at the start of the operation? Any surgeon would immediately answer that with “no”, pointing out that the artificial hip or knee joint prosthesis must be opened at the last minute. But how long have the instruments you use to insert the prosthesis been exposed?

Many people in the general public think of ORs as ultra clean, even sterile, environments. For anyone working in ORs, it is clear that this view is far from the truth. Although modern ORs have strict measures to reduce contamination, the OR environment becomes contaminated with every person entering the operating room. The more people are present in an operating room the higher is the contamination with pathogens that cause infections including SSIs. Especially implant surgery and eye surgery need a very aseptic environment as already a few pathogens can cause infections which are devastating and very expensive to treat.

Despite surgical clothing, every person releases around 200 to 500 bacteria per minute to the environment. Hyg + Med, 12: 205-210 (1987).

Prevention of periprosthetic infections
Periprosthetic infection (PPI) after an endoprosthetic joint replacement is a serious complication. In orthopaedic patient care, infections of endoprosthetic material can mean risking sepsis and even invalidity and amputation of the affected joint. In addition, these events are associated with a considerable financial burden for the clinic (Oldhafer et al. 2007). The resulting costs incurred have thus far only been insufficiently covered by hospitals (Haenle et al. 2012).

The Steristay Sterile Instrument Table currently offers the best protection against intraoperative contamination of instruments – especially during long operations and/or when inserting implants.