Most relevant strategies for preventing surgical site infection after total hip arthroplasty : guideline recommendations and expert opinion

Merollini, Katharina M.D., Zheng, Henry , & Graves, Nicholas (2013) Most relevant strategies for preventing surgical site infection after total hip arthroplasty : guideline recommendations and expert opinion. American Journal of Infection Control, 41(3), pp. 221-226.

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Numerous strategies are available to prevent surgical site infections in hip arthroplasty, but there is no consensus on which might be the best. This study examined infection prevention strategies currently recommended for patients undergoing hip arthroplasty.


Four clinical guidelines on infection prevention/orthopedics were reviewed. Infection control practitioners, infectious disease physicians, and orthopedic surgeons were consulted through structured interviews and an online survey. Strategies were classified as "highly important" if they were recommended by at least one guideline and ranked as significantly or critically important by >/=75% of the experts.


The guideline review yielded 28 infection prevention measures, with 7 identified by experts as being highly important in this context: antibiotic prophylaxis, antiseptic skin preparation of patients, hand/forearm antisepsis by surgical staff, sterile gowns/surgical attire, ultraclean/laminar air operating theatres, antibiotic-impregnated cement, and surveillance. Controversial measures included antibiotic-impregnated cement and, considering recent literature, laminar air operating theatres.


Some of these measures may already be accepted as routine clinical practice, whereas others are controversial. Whether these practices should be continued for this patient group will be informed by modeling the cost-effectiveness of infection prevention strategies. This will allow predictions of long-term health and cost outcomes and thus inform decisions on how to best use scarce health care resources for infection control.

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11 citations in Web of Science®

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ID Code: 61424
Item Type: Journal Article
Refereed: Yes
Additional Information: Merollini, Katharina M D
Zheng, Henry
Graves, Nicholas
Am J Infect Control. 2013 Mar;41(3):221-6. doi: 10.1016/j.ajic.2012.03.027. Epub 2012 Sep 21.
Keywords: Infection control, Orthopedics, Joint replacement, Prevention
DOI: 10.1016/j.ajic.2012.03.027
ISSN: 1527-3296
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 10 Feb 2014 04:40
Last Modified: 19 Jan 2016 04:57

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