Air, antibiotics and sepsis in replacement joints.

Reducing bacterial contamination of the wound by limiting dispersal from the operating staff through the wearing of special occlusive clothing and by employing directional flow ventilating systems substantially reduces the risk of later joint sepsis. Inhibiting growth of those bacteria which reach the wound, by means of perioperative antibiotics, further reduces the incidence of joint sepsis. When all three means are used together the sepsis rate in the years after operation can be reduced to no more than a few per thousand. The hospital costs of any or all of these measures, in terms of the cases of sepsis avoided, are several times less than the costs of treating a septic joint.