Prevention of deep periprosthetic joint infection.

摘要: Although the prevalence of postoperative deep wound infection after total joint arthroplasty has decreased over past few decades, it remains a feared consequence for both surgeons and patients107. Moynihan stated that “every operation in surgery is an experiment bacteriology.”80 This statement provides remarkable insight into seemingly variable unpredictable nature infection. Often, specific mechanism timing bacterial delivery given unknown, usually extremely difficult to prove exact cause individual situation. Despite improved outcomes treatment established periprosthetic infection, prevention meaningful objective. The estimated cost treatment67 at site hip or knee exceeds $50,000. A thorough appreciation respect innumerable factors may contribute essential development over-all approach prevention. concept interdependent relationship among triad bacteria, host, helpful when considering Fig. 1. Infection depends on number virulence bacteria introduced wound, host's ability eliminate these status viability environment. Within this triad, multiple variables can deposition many conditions impair patient's numerous vagaries milieu facilitate infectious process (Table I). Every be influenced by other within triad. For example, effect foreign body absolute required well known29. Venn diagram demonstrating dependent host factors, environment …