Dobson Philip F, Reed Michael R
Trauma and Orthopaedic Surgery, Royal Victoria Infirmary, Newcastle, UK.
EFORT Open Rev. 2020 Oct 26;5(10):604-613. doi: 10.1302/2058-5241.5.200004. eCollection 2020 Oct.
Rates of peri-prosthetic joint infection (PJI) in primary total hip and total knee arthroplasty range between 0.3% and 1.9%, and up to 10% in revision cases. Significant morbidity is associated with this devastating complication, the economic burden on our healthcare system is considerable, and the personal cost to the affected patient is immeasurable.The risk of surgical site infection (SSI) and PJI is related to surgical factors and patient factors such as age, body mass index (BMI), co-morbidities, and lifestyle. Reducing the risk of SSI in primary hip and knee arthroplasty requires a multi-faceted strategy including pre-operative patient bacterial decolonization, screening and avoidance of anaemia, peri-operative patient warming, skin antisepsis, povidone-iodine wound lavage, and anti-bacterial coated sutures.This article also considers newer concepts such as the influence of bearing surfaces on infection risk, as well as current controversies such as the potential effects of blood transfusion, laminar flow, and protective hoods and suits, on infection risk. Cite this article: 2020;5:604-613. DOI: 10.1302/2058-5241.5.200004.
初次全髋关节置换术和全膝关节置换术中人工关节周围感染（PJI）的发生率在0.3%至1.9%之间，翻修病例中高达10%。这种严重的并发症会导致显著的发病率，给我们的医疗系统带来相当大的经济负担，对受影响患者的个人代价更是难以估量。手术部位感染（SSI）和PJI的风险与手术因素以及患者因素有关，如年龄、体重指数（BMI）、合并症和生活方式。降低初次髋膝关节置换术中SSI的风险需要多方面的策略，包括术前患者细菌去定植、筛查和避免贫血、围手术期患者保暖、皮肤消毒、聚维酮碘伤口灌洗以及抗菌涂层缝线。本文还探讨了一些新的概念，如承重表面对感染风险的影响，以及当前的争议问题，如输血、层流、防护头罩和防护服对感染风险的潜在影响。引用本文：2020;5:604 - 613。DOI: 10.1302/2058 - 5241.5.200004。
