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Campoccia D, Montanaro L, Speziale P, Arciola CR. Antibiotic-loaded biomaterials and the risks for the spread of antibiotic resistance following their prophylactic and therapeutic clinical use. Biomaterials 2010; 31:6363-77. [DOI: 10.1016/j.biomaterials.2010.05.005] [Citation(s) in RCA: 300] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Accepted: 05/07/2010] [Indexed: 12/28/2022]
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Walls RJ, Roche SJ, O’Rourke A, McCabe JP. Surgical site infection with methicillin-resistant Staphylococcus aureus after primary total hip replacement. ACTA ACUST UNITED AC 2008; 90:292-8. [DOI: 10.1302/0301-620x.90b3.20155] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We have analysed the management and clinical outcome of a series of consecutive patients who had a total hip replacement and developed post-operative surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus. The incidence of this infection was 1% over a period of five years. We studied SSI in 15 patients (16 infections) with a mean age of 72.7 years (53 to 81). In all, 12 of the infections occurred early and half of the infections involved the prosthesis, resulting in an increase of 11-fold in the cumulative hospital stay. Methicillin-resistant Staph. aureus was successfully eradicated in all the patients after a mean follow-up of 53.6 months (25 to 88). Superficial incisional infections resolved after antibiotic therapy alone while deep infections required multiple operative debridements. Attempted retention of the implant in early organ space infections was successful in only one of five patients. Only three patients with implant-level infections obtained a pain-free, functional prosthesis while a further three required excision arthroplasty. We have formulated a protocol of treatment which may serve as a guide in the management of these infections.
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Affiliation(s)
- R. J. Walls
- Department of Orthopaedic and Trauma Surgery, Merlin Park University Hospital, Dublin Road, Galway, Ireland
| | - S. J. Roche
- Department of Orthopaedic and Trauma Surgery, Merlin Park University Hospital, Dublin Road, Galway, Ireland
| | - A. O’Rourke
- Department of Orthopaedic and Trauma Surgery, Merlin Park University Hospital, Dublin Road, Galway, Ireland
| | - J. P. McCabe
- Department of Orthopaedic and Trauma Surgery, Merlin Park University Hospital, Dublin Road, Galway, Ireland
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