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术前使用氯己定沐浴预防初次全髋关节置换术中的假体周围感染

The Prevention of Periprosthetic Joint Infection in Primary Total Hip Arthroplasty Using Pre-Operative Chlorhexidine Bathing.

作者信息

Su Wen-Chi, Lai Yu-Chin, Lee Cheng-Hung, Shih Cheng-Min, Chen Chao-Ping, Hung Li-Ling, Wang Shun-Ping

机构信息

Department of Nursing, Taichung Veterans General Hospital, Taichung 407, Taiwan.

Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407, Taiwan.

出版信息

J Clin Med. 2021 Jan 23;10(3):434. doi: 10.3390/jcm10030434.

Abstract

Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a devastating complication. The aim of this study was to investigate whether preoperative bathing using chlorhexidine gluconate (CHG) before THA can effectively reduce the postoperative PJI rate. A total of 933 primary THA patients, with the majority being female (54.4%) were included in the study. Primary THA patients who performed preoperative chlorhexidine bathing were assigned to the CHG group (190 subjects), and those who did not have preoperative chlorhexidine bathing were in the control group (743 subjects). The effects of chlorhexidine bathing on the prevention of PJI incidence rates were investigated. Differences in age, sex, and the operated side between the two groups were not statistically significant. Postoperative PJI occurred in four subjects, indicating an infection rate of 0.43% (4/933). All four infected subjects belonged to the control group. Although the PJI cases were significantly more in the control group than in the CHG group, statistical analysis revealed no statistical significance in the risk of PJI occurrence between the two groups ( = 0.588). Preoperative skin preparation by bathing with a 2% chlorhexidine gluconate cleanser did not produce significant effects on the prevention of postoperative PJI in primary THA.

摘要

全髋关节置换术(THA)后假体周围关节感染(PJI)是一种严重的并发症。本研究的目的是调查THA术前使用葡萄糖酸氯己定(CHG)沐浴是否能有效降低术后PJI发生率。共有933例初次THA患者纳入本研究,其中大多数为女性(54.4%)。术前进行氯己定沐浴的初次THA患者被分配到CHG组(190例),未进行术前氯己定沐浴的患者被分入对照组(743例)。研究了氯己定沐浴对预防PJI发生率的影响。两组患者的年龄、性别和手术侧别差异无统计学意义。术后有4例发生PJI,感染率为0.43%(4/933)。所有4例感染患者均属于对照组。虽然对照组的PJI病例明显多于CHG组,但统计分析显示两组之间PJI发生风险无统计学意义( = 0.588)。术前用2%葡萄糖酸氯己定清洁剂沐浴进行皮肤准备对预防初次THA术后PJI无显著效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe1/7865798/0a5ca06cd966/jcm-10-00434-g001.jpg

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