| 1 |
Case Study
|
A small pilot study to evaluate the effects of a silver-coated antimicrobial dressing* on the incidence of infection in total knee arthroplasty Eric Abood, PA, Ira J. Guttentag, MD, FACS, Florida Medical Clinic, Tampa, FL The reported incidence of infection in total knee arthroplasty varies between 0.5%-12%. A deep infection can be devastating and result in major morbidity, often requiring additional surgery and prolonged antimicrobial therapy. The microbial source for a deep prosthetic infection has been grouped into three sources by Gaine et al; Direct contact with wound or air-bourne colonization during the procedure, blood-bourne contamination during or after the procedure or the spread of a superficial wound infection deep to the fascia lata leading to periprosthetic infection. The aim of our evaluation was to determine the effects of a silver-coated antimicrobial barrier dressing on the incidence of infection post-operatively, when used as a prophylactic measure, to counteract the possibility of a superficial infection. The dressing has been proven in vitro to be effective in killing over 150 pathogens including staphylococcus aureus and MRSA (Smith & Nephew Scientific #7) and we wanted to transfer this data in an in-vivo situation. A total of 20 patients have been included in the evaluation. All patients were >18 years of age, men or non-pregnant women that have undergone a total knee arthroplasty at the Florida Medical Center. The evaluation was non-comparative and non-randomized in design but patients that were suitable for inclusion were treated with the evaluation dressing sequentially. Patients were observed for any clinical signs of infection at 48 hours, 72 hours and day 10 post-operatively. The full poster presentation will summarize the results of the evaluation and brief conclusions will be made. Suggestions for improvements in the evaluation design and further investigation into a larger comparative study will be made. Our initial observations are that there has been no incidence of infection after the use of this dressing. *ACTICOAT, Smith & Nephew Wound Management Inc. Largo, FL.*ACTICOAT 7, Smith & Nephew Wound Management Inc. Largo, FL Blom AW, Brown J, Taylor, et al. Infection after total knee arthroplasty. J Bone Joint Surg. 2004;86ÐB(5). Gaine WJ, Ramamohan NA, Hussein, et al. Wound infection in hip and knee arthroplasty. J Bone Joint Surg. 2000;82-B(4) Lazzarini L, Pellizzer G, Stecca C, et al. Postoperative infections following total knee replacement: an epidemiological study. J Chemother. 2001;13(2):182Ð187 Smith & Nephew data on file. Scientific Background #7. Broad-spectrum antibacterial activity of Acticoat (with Nanocrystalline silver) burn dressing. .. |
|