Namdari Surena, Voleti Pramod B, Baldwin Keith D, Lee Gwo-Chin
Department of Orthopedic Surgery, Hospital of the University of Pennsylvania, 2 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.
Orthopedics. 2011 Sep 9;34(9):e541-5. doi: 10.3928/01477447-20110714-09.
No study has examined infection rates in "clean" cases following "dirty" cases. This study evaluated patients undergoing elective primary total joint arthroplasties performed in operating rooms following cases of known infection for development of postoperative infection. A retrospective review of all elective primary total joint arthroplasties performed over a 5-year period at our institution was conducted. Patients who underwent primary total joint arthroplasties that followed cases of known infection in the same operating room were examined (minimum follow-up of 1 year) to determine the occurrence of infection based on culture data and subsequent procedures. Thirty-nine total joint arthroplasties (27 total knee arthroplasties and 12 total hip arthroplasties) in 35 patients were performed following cases of known infection in the same operating room. Of these patients, 1 (2.6%) developed a periprosthetic joint infection. The infecting organism (Propionibacterium acnes) was the same as that isolated from the preceding "dirty" case. Further investigation is necessary to determine whether performing primary total joint arthroplasties immediately following "dirty" cases increases risk of infection.
尚无研究调查“污染”病例之后的“清洁”病例的感染率。本研究评估了在已知感染病例之后于手术室进行择期初次全关节置换术的患者术后感染的发生情况。对本机构在5年期间内进行的所有择期初次全关节置换术进行了回顾性研究。检查了在同一手术室中于已知感染病例之后接受初次全关节置换术的患者（最短随访1年），根据培养数据和后续手术确定感染的发生情况。35例患者中，有39例全关节置换术（27例全膝关节置换术和12例全髋关节置换术）是在同一手术室的已知感染病例之后进行的。在这些患者中，有1例（2.6%）发生了假体周围关节感染。感染病原体（痤疮丙酸杆菌）与之前“污染”病例中分离出的病原体相同。有必要进一步调查在“污染”病例之后立即进行初次全关节置换术是否会增加感染风险。
