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Prophylaxis in Orthopedic Surgery

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Orthopedic Infection

Part of the book series: Clinical Topics in Infectious Disease ((CLIN.TOP.INFECT))

Abstract

Modern surgical antisepsis is now more than 120 years old. After Louis Pasteur’s discovery that bacteria caused fermentation, Joseph Lister recognized that bacteria also caused putrifaction in wounds. He utilized this information in 1865, in the treatment of a patient with an open tibial fracture, to which he applied lint dipped in liquid carbolic acid (38). His concept of chemical sterilization of the wound before bacteria could multiply sufficiently provided the groundwork for our modern era of surgical antisepsis.

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References

  1. Ahlbert A, Carlsson A, Lindberg L: Hematogenous infections in total joint replacement. Clin Orthop 137:69, 1978.

    Google Scholar 

  2. Andrews HJ, Arden GP, Hart GM, et al: Deep infection after total hip replacement. J Bone Joint Surg 63B:53, 1981.

    Google Scholar 

  3. Boyd RJ, Burke JF, Colton T: A double-blind clinical trial of prophylactic antibiotics in hip fractures. J Bone Joint Surg 55A:1251, 1973.

    Google Scholar 

  4. Buchholz HW, Engelbrecht H: Uber die Depotwirkung einiger Antibiotica bei Vermischung mit dem kunstharz Palacos. Chirurg 41:511, 1970.

    PubMed  CAS  Google Scholar 

  5. Buchholz HW, Gartmann HD: Infektionsprophylaxe und operative Behandlung der Schleichenden tiefen Infektion bei der totalen Endoprothese. Chirurg 43:446, 1972.

    PubMed  CAS  Google Scholar 

  6. Burke JF: The effective period of preventative antibiotic action in experimental incisions and dermal lesions. Surgery 50:161, 1961.

    PubMed  CAS  Google Scholar 

  7. Burnett JW, Gustilo RB, Williams DN, Kind AC: Prophylactic antibiotics in hip fractures: a double-blind, propective study. J Bone Joint Surg 62A:457, 1980.

    Google Scholar 

  8. Carlsson AS, Lidgrin L, Lindberg L: Prophylactic antibiotics against early and late infections after total hip replacements. Acta Orthop Scand 48:405, 1977.

    Article  PubMed  CAS  Google Scholar 

  9. Charnley J: A clean air operating enclosure. Br J Surg 51:202, 1964.

    Article  PubMed  CAS  Google Scholar 

  10. Conte JE, Jacob LE, Polk HC: Antibiotic Prophylaxis in Surgery. Philadelphia, JB Lippincott, 1984, pp 27–57.

    Google Scholar 

  11. Conte JE, Jacob LE, Polk HC: Antibiotic Prophylaxis in Surgery. Philadelphia, JB Lippincott, 1984, pp 111–122.

    Google Scholar 

  12. Costerton JW, Irvin RT, Chang KJ: The bacterial glycocalyx in nature and disease. Annu Rev Microbiol 35:299, 1981.

    Article  PubMed  CAS  Google Scholar 

  13. Crile G Jr, Fulton JR: Appendicitis, with emphasis on the use of penicillin. US Nav Med Bull 45:464, 1945.

    Google Scholar 

  14. Ericson C, Lidgren L, Lindberg L: Cloxacillin in the prophylaxis of post-operative infections of the hip. J Bone Joint Surg 55A:808, 1973.

    Google Scholar 

  15. Fauley GB, Duggan TL, Stormont RT, et al: The use of penicillin in the treatment of peritonitis. JAMA 126:1132, 1944.

    CAS  Google Scholar 

  16. Fekety R: Vancomycin. Med Clin North Am 66:175, 1982.

    PubMed  CAS  Google Scholar 

  17. Fitzgerald RH, Peterson LAF, Washington JA, et al: Bacterial colonization of wounds and sepsis in total hip arthroplasty. J Bone Joint Surg 55A:1242, 1973.

    Google Scholar 

  18. Gatell JM, Riba J, Lozano ML, Mana J, Ramon R, Sanmiguel JG: Prophylactic cefamandole in orthopaedic surgery. J Bone Joint Surg 66A:1219, 1984.

    Google Scholar 

  19. Goldenberg DL, Brandt KD, Cathcart ES, Cohen AS: Acute arthritis caused by gram-negative bacilli: a clinical characterization. Medicine 53:197, 1974.

    Article  PubMed  CAS  Google Scholar 

  20. Goldenberg DL, Reed JJ: Bacterial arthritis. N Engl J Med 312(12):764, 1985.

    Article  PubMed  CAS  Google Scholar 

  21. Goven JRW: Mucoid strains of Pseudomonas aeruginosa: the influence of culture medium on the stability of mucous production. J Med Microbiol 8:513, 1975.

    Article  Google Scholar 

  22. Griffin WD, Silverstein J, Hardt HG Jr, et al: Prophylactic chemotherapy in appendicitis. JAMA 133:907, 1947.

    CAS  Google Scholar 

  23. Gristina AG, Costerton JW: Bacterial adherence and the glycocalyx and their role in musculoskeletal infection. Orthop Clin North Am 15:517, 1984.

    PubMed  CAS  Google Scholar 

  24. Gustilo RB, Anderson JT: Prevention of infection in the treatment of 1,025 open fractures of long bones. J Bone Joint Surg 58A:453, 1976.

    Google Scholar 

  25. Gustilo RB, Mendoza RM, Williams DN: Problems in the management of type III (severe) open fractures. J Trauma 24(8), 1984, pp 742–745.

    Article  PubMed  CAS  Google Scholar 

  26. Hamilton CW, Russo J, Romankiewicz JA, Fitzgerald RH: Overview of antimicrobial use in musculoskeletal infection, in Musculoskeletal Infections: Recognition, Prevention and Management, Fitzgerald RH (ed). New York, ADIS Press Inc, 1982, pp 8–42.

    Google Scholar 

  27. Henley MB, Jones RE, Wyatt RWB, Hofmann A, Cohen RL: Prophylaxis with cefamandole nafate in elective orthopaedic surgery. Clin Orthop 209:249, 1986.

    PubMed  Google Scholar 

  28. Hesseltine HC, Kephart SB: Prophylactic use of penicillin and streptomycin in certain obstetric conditions. Am J Obstet Gynecol 59:184, 1950.

    PubMed  CAS  Google Scholar 

  29. Hill C, Flamant R, Mazas F, Evrard J: Prophylactic cefazolin versus placebo in total hip replacement. Lancet 1:795, 1981.

    Article  PubMed  CAS  Google Scholar 

  30. Hunter GA, Dandy D: The natural history of the patient with an infected total hip replacement. J Bone Joint Surg 59B:293, 1977.

    Google Scholar 

  31. Irvine R, Johnson BL, Amstutz HC: The relationship of genitourinary tract procedures and deep sepsis after total hip replacements. Surg Gynecol Obstet 139:701, 1974.

    PubMed  CAS  Google Scholar 

  32. Jensen NK, Johnsrud LW, Nelson MC: Local implantation of sulfonamide in compound fractures. Surgery 6:1, 1939.

    Google Scholar 

  33. Keettel WC, Plass ED: Prophylactic administration of penicillin to obstetric patients. JAMA 142:324, 1950.

    CAS  Google Scholar 

  34. Keettel WC, Scott JW, Plass ED: An evaluation of prophylactic penicillin administration to parturient women. Am J Obstet Gynecol 58:335, 1949.

    PubMed  CAS  Google Scholar 

  35. Kind AC, Williams DN: Antibiotics in open fractures, in Management of Open Fractures and Their Complications, Gustilo RB (ed). Philadelphia, WB Saunders, 1982, pp 60–62.

    Google Scholar 

  36. Lautenschlayer EP, Marshall GW, Marks KE, Schwartz J, Nelson CL: Mechanical strength of acrylic bone cements implanted with antibiotics. J Biomed Mater Res 10:837, 1976.

    Article  Google Scholar 

  37. Lidwell OM, Lowbury EJL, Whyte W, Blowers R, Stanley SJ, Lowe D: Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomized study. Br Med J 285:10, 1982.

    Article  CAS  Google Scholar 

  38. Lister J: The antiseptic system: on a new method of treating compound fracture, abscess, etc., with observations on the conditions of suppuration. Lancet 1:326, 1867.

    Article  Google Scholar 

  39. Marks KE, Nelson CL, and Lautenschlayer EP: Antibiotic-implanted acrylic bone cement. J Bone Joint Surg 58A:358, 1976.

    CAS  Google Scholar 

  40. McCue SF, Berg EW, Saunders EA: Efficacy of double gloving as a barrier to microbial contamination during total joint arthroplasty. J Bone Joint Surg 63A:811, 1981.

    Google Scholar 

  41. McKittrick LS, Wheelock FC Jr: The routine use of antibiotics in elective abdominal surgery. Surg Gynecol Obstet 99:376, 1954.

    PubMed  CAS  Google Scholar 

  42. Meleney FL: A statistical analysis of a study of the prevention of infection in soft part wounds, compound fractures and burns, with special reference to the sulfonamides. Surg Gynecol Obstet 80:263, 1945.

    CAS  Google Scholar 

  43. Miles AA, Miles EM, Burke J: The value and duration of defense reactions of the skin to primary lodgment of bacteria. Br J Exp Pathol 38:79, 1957.

    PubMed  CAS  Google Scholar 

  44. Miller WE, Counts GW: Orthopaedic infections: a prospective study of 378 clean procedures. South Med J 68:386, 1975.

    Article  PubMed  CAS  Google Scholar 

  45. Murray WR: Use of antibiotic-containing bone cement. Clin Orthop 190:89, 1984.

    PubMed  CAS  Google Scholar 

  46. Nelson CL, Green TG, Porter RA, Warren RD: One day versus seven days of prevention antibiotic therapy in orthopaedic surgery. Clin Orthop 176:258, 1983.

    PubMed  Google Scholar 

  47. Panush RW, Petty RW: Inhibition of human lymphocyte responses by methylmethacrylate. Clin Orthop 132:266, 1978.

    Google Scholar 

  48. Patzakis MJ, Harvey JP, Tyler D: The role of antibiotics in the management of open fractures. J Bone Joint Surg 56A:532, 1974.

    Google Scholar 

  49. Pavel A: Prophylactic antibiotics in elective orthopaedic surgery: a prospective study of 1,591 cases. South Med J 70(1):50, 1977.

    Article  PubMed  Google Scholar 

  50. Pavel A, Smith RL, Ballard A, Larsen IJ: Prophylactic antibiotics in clean orthopaedic surgery. J Bone Joint Surg 56A:777, 1974.

    Google Scholar 

  51. Peterson PK, Wilkinson BJ, Kim Y, Schmeling D, Quie PG: Influence of encapsulation on staphylococcal opsonization and phagocytosis by human polymorphonuclear leukocytes. Infect Immunol 19:943, 1978.

    CAS  Google Scholar 

  52. Petty RW: Effect of methylmethacrylate on bacterial inhibiting properties of normal human serum. Clin Orthop 132:266, 1978.

    PubMed  CAS  Google Scholar 

  53. Petty RW: The effect of methylmethacrylate on bacterial phagocytosis and killing by human poly morphonculear leukocytes. J Bone Joint Surg 60A:752, 1978.

    Google Scholar 

  54. Petty RW: The effect of methylmethacrylate on chemotaxis of polymorphonuclear leukocytes. J Bone Joint Surg 60A:492, 1978.

    CAS  Google Scholar 

  55. Petty RW, Bryan RS, Coventry MB, Peterson LFA: Infection after total knee arthroplasty. Orthop Clin North Am 6:1005, 1975.

    PubMed  CAS  Google Scholar 

  56. Petty RW, Calwell JR: The effect of methylmethacrylate on complement activity. Clin Orthop 128:354, 1977.

    PubMed  CAS  Google Scholar 

  57. Petty RW, Spanier S, Shuster JJ, Silverthorne C: The influence of skeletal implants on incidence of infection. J Bone Joint Surg 67A:1236, 1985.

    Google Scholar 

  58. Polk HC Jr, Lopez-Mayor JF: Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery 66:97, 1969.

    PubMed  Google Scholar 

  59. Pollard JP, Hughes SPF, Scott JE, Evans MJ, Benson MKD: Antibiotic prophylaxis in total hip replacement. Br Med J 1:707, 1979.

    Article  PubMed  CAS  Google Scholar 

  60. Prince CL: The prevention of urinary tract infection following transurethral prostatic resection by combined use of sulfadiazine and penicillin. J Urol 56:121, 1946.

    PubMed  CAS  Google Scholar 

  61. Rhinelander FW, Nelson CL, Stewart RD, Stewart CL: Experimental reaming of the proximal femur and acrylic cement implantations. Clin Orthop 141:74, 1979.

    PubMed  Google Scholar 

  62. Roce RP, Yoshikawa TT: Primary skeletal infections in heroin users: a clinical characterization, diagnosis and therapy. Clin Orthop 144:238, 1979.

    Google Scholar 

  63. Sanders CC: Novel resistance selected by the new expanded spectrum cephalosporins: a concern. J Infect Dis 147:585, 1983.

    Article  PubMed  CAS  Google Scholar 

  64. Schulitz KP, Winkelmann W, Schoening B: The prophylactic use of antibiotics in alloarthroplasty of the hip joint for coxarthrosis: a randomized study. Arch Orthop Trauma Surg 96:79, 1980.

    Article  PubMed  CAS  Google Scholar 

  65. Schurman DJ, Burton DS, Kajiyama G, Moser K, Nagel DA: Sodium cephapirin disposition and distribution into human bone. Curr Ther Res 20:194, 1976.

    PubMed  CAS  Google Scholar 

  66. Schurman DJ, et al: Transactions of the 23rd Annual Meeting of the Orthopaedic Research Society. Chicago, Adept Printing Inc, 1977:30.

    Google Scholar 

  67. Schurman DJ, Hirshman HP, Burton DS: Cephalothin and cefamandole penetration into bone, synovial fluid and wound drainage fluid. J Bone Joint Surg 62A:981, 1980.

    Google Scholar 

  68. Schurman DJ, Hirshman HP, Kajiyama G, Moser K, Burton DS: Cefazolin concentrations in bone and synovial fluid. J Bone Joint Surg 60A:359, 1978.

    CAS  Google Scholar 

  69. Schurman DJ, Johson BL, Amstutz HC: Knee joint infections with Staphylococcus aureus and micrococcus species. J Bone Joint Surg 57A:40, 1975.

    Google Scholar 

  70. Schurman DJ, Kajiyama G, Nagel DA: Escherichia coli infections in rabbit knee joints. J Bone Joint Surg 62A:620, 1980.

    CAS  Google Scholar 

  71. Schurman DJ, Swenson LW, Piziali RL: Bone cement with and without antibiotics: a study of mechanical properties, in The Hip: Proceedings of the Sixth Open Scientific Meeting of The Hip Society. St. Louis, CV Mosby, 1978, pp 87–96.

    Google Scholar 

  72. Schurman DJ, Trindale C, Hirshman HP, Moser K, Kajiyama G, Steven P: Antibiotic-acrylic bone-cement composites. J Bone Joint Surg 60A:978, 1978.

    Google Scholar 

  73. Schurman DJ, Wheeler R: Gram-negative bone and joint infections. Clin Orthop 134:268, 1978.

    PubMed  Google Scholar 

  74. Schurman DJ, Woolson ST: Prophylactic antibiotics in orthopaedic surgery. Orthopaedics 7(10): 1603, 1984.

    Google Scholar 

  75. Stafford ES: The value of sulfathiazole in the treatment of peritonitis and abscesses of appendical origin. Surg Gynecol Obstet 74:368, 1942.

    Google Scholar 

  76. Tengve G, Kjellander J: Antibiotic prophylaxis in operations on trochanteric femoral fractures. J Bone Joint Surg 60A:97, 1978.

    Google Scholar 

  77. Thompson RL, Wright AJ: Antimicrobial therapy in musculoskeletal surgery. Orthop Clin North Am 15(3):547, 1984.

    PubMed  CAS  Google Scholar 

  78. Visuri T, Antila P, Laurent LE: A comparison of dicloxacillin and ampicillin in the antibiotic prophylaxis of total hip replacement. Ann Chir Gynaecol 65:58, 1976.

    PubMed  Google Scholar 

  79. Wahlig H, Bucholz HW: Experimentelle und Klinische Untersuchungen zur Freisetzung von Gentamycin aus einem Knochenzement. Chirug 43:441, 1972.

    CAS  Google Scholar 

  80. Wahlig H, Dingeldein E: Antibiotics and bone cements. Experimental and clinical long-term observations. Acta Orthop Scand 51:49, 1980.

    Article  PubMed  CAS  Google Scholar 

  81. Wahlig H, Hameister W, Grieben A: Uber die Freisetzung von Gentamycin aus Polymethylmethacrylate. I Experimentelle Untersuchungen in vitro. Arch Klin Chir 331:169, 1972.

    CAS  Google Scholar 

  82. Wahlig H, Schliep HJ, Bergmann R, Hameister W, Grieben A: Uber die Freisetzung von Gentamycin aus Polymethymethacrylate. II Experimentelle. Unter Suchungen in vivo. Arch Klin Chir 331:193, 1972.

    CAS  Google Scholar 

  83. Weinstein AJ; Antibiotics used in orthopaedics and the role of the infectious disease consultant, in Challenge of the 80’s: Prevention and Management of Sepsis in Orthopaedic Surgery. Chicago, Eli Lilly, 1982.

    Google Scholar 

  84. Williams DN, Gustilo RB: The use of prevention antibiotics in orthopaedic surgery. Clin Orthop 190:83, 1984.

    PubMed  Google Scholar 

  85. Williams DN, Gustilo RB, Beverly R, Kind AC: Bone and serum concentrations of five cephalosporin drugs. Relevance to prophylaxis and treatment in orthopaedic surgery. Clin Orthop 179:253, 1983.

    PubMed  Google Scholar 

  86. Willkins RF, Healey LA, Decker JL: Acute infectious arthritis in the aged and chroncially ill. Arch Intern Med 106:354, 1960.

    Google Scholar 

  87. Wilson DP, Jr: Joint replacement. South Med J 70 (Suppl. 1):55, 1977.

    Article  PubMed  Google Scholar 

  88. Wilson PD, Salvati EA, Blumenfeld EL: The problem of infections in total prosthetic arthroplasty of the hip. Surg Clin North Am 55:1431, 1975.

    PubMed  Google Scholar 

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Goodman, S.B., Schurman, D.J. (1988). Prophylaxis in Orthopedic Surgery. In: Schlossberg, D. (eds) Orthopedic Infection. Clinical Topics in Infectious Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3870-6_11

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  • DOI: https://doi.org/10.1007/978-1-4612-3870-6_11

  • Publisher Name: Springer, New York, NY

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