Pressemitteilung

American Practitioner of Infection Control

INFECTION AFTER TOTAL KNEE REPLACEMENT infection in the total hip or knee, this infection is a postoperative deep wound infection that developed around these joints. The absolute majority of these infections is caused by bacteria that landed in the operation wound during the total joint surgery. These bacteria are living with all of us in a close and innocent partnership, they cannot exist without us. Yet, when in contact with an artificial total joint, these bacteria change their character from a partner to an enemy.

cost of infection after total hip replacement and total knee replacement The total cost for the 3 500 - 4 000 postoperative wound infections after total hip and knee replacements that occur annually in the USA is about 200 millions $$'. (Spangehl 1999)

Bacteria living in hospitals are dangerous The bacteria living in the hospitals are special. The majority of them developed resistance against the antibiotics used in that hospital. After some days, these resistant bacteria occupy (contaminate ) the body surface of every new visitor of the hospital, replacing his / her original bacteria which once were sensitive to antibiotics.

TREATMENT OF THE TOTAL HIP INFECTION Once the infection gets hold in the total hip joint, treatment of the infection in the total hip with antibiotic only is not effective. On the contrary, it is dangerous because it produces antibiotics resistant bacterial strains it may trigger allergy against antibiotics in the patient. Once the infecting bacteria landed on the surface of the total joint they produce quickly a slime envelope that protects them effectively against the action of antibiotics. The prosthesis and the soft tissues have slime forming bacteria firmly adherent to them. The surgeon must remove the infected total joint prosthesis with tissues around it to get rid of the slime forming bacteria. First when the the slime forming bacteria have been removed the antibiotic treatment will be effective against the few bacteria that remained scattered in the tissues. The most often used, and the most often successful method is the staged exchange of the infected prosthesis. This method uses two operations: in the first stage the surgeon removes the infected total hip joint, in the second stage the surgeon implants a new total joint prosthesis.

deep postoperative wound infection (PWI) The absolute majority of these infections is caused by bacteria that landed in the operation wound during the total joint surgery. The bacteria-carrying particles (mainly skin scales, but also droplets coming from mouths and noses) are generated by the operation room staff members & the patient. (Friberg 1998)

Prosthetic Joint Infection Device associated infections

PERSISTENCE OF INFECTION IN THE VICINITY OF AN IMPLANT It is a general clinical observation that infection around a foreign body cannot be cured. Implantat-associated infection is mainly introduced during surgery or before complete wound healing

Orthopaedic infections and osteomyelitis inflammation of the bone and its marraw contents. acute hematogenous osteomyelitis from exogenous contamination

PROSTHETIC JOINT ASSOCIATED INFECTIONS Exogenous Infection Implantat-associated infection is mainly introduced during surgery or before complete wound healing, Hematogenous Infection, TREATMENT OPTIONS OF PROSTHETIC JOINT ASSOCIATED INFECTION

Reduction of infection with laminar air flow Laminar flow ventilation is used in modern orthopaedic operating theatres to reduce the number of infective organisms present in the air, which may lead to post-operative wound infection. This is of particular significance in joint prosthesis surgery, where delayed and deep-seated post-operative infectionmay result in poor patient outcomes and substantial costs, both to patients and health care providers.

A new system fights hospital infections To fight hospital infections and increasingly resistant bacteria Normeditec has developed Toul Mobile Laminar Airflow .Hospital infections are immensely dangerous as the pathogenes causing them are increasingly resistant to most of the commonly used antibiotics. In 1974, only 2 % of Staphylococcus aureus infections in the USA were MRSA (methicillin-resistant). By 2003, that figure had soared to 57 %, and now is over 60 %. Nosocomial infections are the fourth largest killer in the United States: there, every year two million patients contract infections in hospitals, and an estimated 103,000 die as a result, that means as many deaths as from AIDS, breast cancer and traffic accidents combined. The use of ultraclean airflow may help to transmit airborne particles from the surgical team onto the operating field and thereby increase direct airborne contamination of the wound. Every minute, an individual emits thousands of airborne particles carrying bacteria that may contaminate an open surgical wound