Weinrauch Patrick
Department of Orthopaedics, Prince Charles Hospital, and School of Engineering Systems, Queensland University of Technology, Queensland, Australia.
ANZ J Surg. 2005 Oct;75(10):887-8. doi: 10.1111/j.1445-2197.2005.03546.x.
Closed suction drainage after joint arthroplasty is common practice in many institutions. The purpose of this study was to determine the correlation between routine drain tip culture and the diagnosis of superficial or deep postoperative wound infection after primary knee and hip replacement.
Over a 12-month period, drain tips were retrieved and cultured in all patients who underwent unilateral primary total knee or hip replacement with the use of closed suction drainage. A total of 393 cultures was performed in 387 patients (145 hip replacements, 242 knee replacements). Patients were followed for an average of 8.9 months after surgery to assess for postoperative wound infection.
Three patients had a positive drain tip culture, none of which were diagnosed with superficial or deep infection. Four patients (1%) were diagnosed with deep infection, 16 (4.1%) with superficial infection. No patient with either superficial or deep infection had a positive drain tip culture after their index procedure. The sensitivity of routine drain tip culture for the diagnosis of postoperative infection in primary joint replacement was 0% and specificity was 99.2%.
These data do not support the practice of routine drain tip culture after primary hip or knee replacement for the diagnosis of postoperative infection.
关节置换术后进行闭式吸引引流在许多机构中是常见的做法。本研究的目的是确定常规引流管尖端培养与初次膝关节和髋关节置换术后浅表或深部手术伤口感染诊断之间的相关性。
在12个月的时间里，对所有接受单侧初次全膝关节或髋关节置换并使用闭式吸引引流的患者的引流管尖端进行采集和培养。387例患者（145例髋关节置换，242例膝关节置换）共进行了393次培养。患者术后平均随访8.9个月以评估手术伤口感染情况。
3例患者引流管尖端培养呈阳性，但均未被诊断为浅表或深部感染。4例患者（1%）被诊断为深部感染，16例（4.1%）为浅表感染。初次手术后，无论是浅表感染还是深部感染的患者，其引流管尖端培养均未呈阳性。初次关节置换术后常规引流管尖端培养对术后感染诊断的敏感性为0%，特异性为99.2%。
这些数据不支持在初次髋关节或膝关节置换术后常规进行引流管尖端培养以诊断术后感染的做法。
