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Frisch NB, Kadri OM, Tenbrunsel T, et al. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today. 2017;3(4):294-297doi: 10.1016/j.artd.2017.03.005.
Frisch, N. B., Kadri, O. M., Tenbrunsel, T., Abdul-Hak, A., Qatu, M., & Davis, J. J. (2017). Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplasty today, 3(4), 294-297. https://doi.org/10.1016/j.artd.2017.03.005
Frisch, Nicholas B, et al. "Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty." Arthroplasty today vol. 3,4 (2017): 294-297. doi: https://doi.org/10.1016/j.artd.2017.03.005
Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today. 2017 May 12;3(4):294-297. doi: 10.1016/j.artd.2017.03.005. eCollection 2017 Dec. PMID: 29204500; PMCID: PMC5712016.
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Arthroplast Today. 2017 May 12;3(4):294-297. doi: 10.1016/j.artd.2017.03.005. eCollection 2017 Dec.

Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty.

Arthroplasty today

Nicholas B Frisch, Omar M Kadri, Troy Tenbrunsel, Abraham Abdul-Hak, Mossub Qatu, Jason J Davis

Affiliations

  1. Henry Ford Health System, Department of Orthopaedic Surgery, Detroit, MI, USA.
  2. Wayne State University School of Medicine, Detroit, MI, USA.

PMID: 29204500 PMCID: PMC5712016 DOI: 10.1016/j.artd.2017.03.005

Abstract

BACKGROUND: Surgical site irrigation during total hip (THA) and total knee (TKA) arthroplasty is a routine practice among orthopaedic surgeons to prevent periprosthetic joint infection. The purpose of this study was to evaluate the effect of chlorhexidine gluconate (CHG) irrigation on infection rates following THA and TKA.

METHODS: Arthroplasties performed before September 2014 served as controls. THA performed before September 2014 (N = 253) underwent intraoperative irrigation with 0.9% saline followed by a 2-minute soak with <2% dilute povidone-iodine. TKA (N = 411) patients underwent only intraoperative saline irrigation. After October 2014, all patients (248 TKA and 138 THA) received intraoperative irrigation with 0.9% saline and periodic 0.05% CHG solution followed by a final 1-minute soak in CHG with immediate closure afterward.

RESULTS: In this 2:1 comparison of consecutive patients, there were no differences in patient demographics between the 2 groups. No difference was noted in wound healing concerns subjectively, and no statistically significant association in nonsurgical site infections, superficial surgical site infection, and deep surgical site infection rates between the 2 groups (nonsurgical site infections [THA:

CONCLUSIONS: We were unable to discern a difference in infection rates between chlorhexidine irrigation and our prior protocols using dilute Betadine for THA and 0.9% saline for TKA. The theoretic advantages of dilute CHG retention during closure appear to be safe without infectious concerns.

Keywords: Irrigation; Lavage; Periprosthetic joint infection (PJI); Total hip arthroplasty (THA); Total knee arthroplasty (TKA)

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