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Prosthesis-related infection. Etiology, prophylaxis and diagnosis (a review).

Authors: A B, Wymenga; B J, Van Dijke; J R, Van Horn; T J, Slooff;

Prosthesis-related infection. Etiology, prophylaxis and diagnosis (a review).

Abstract

The recent literature concerning prosthesis-related infection is reviewed with respect to etiology, prophylaxis and diagnosis. Most prosthesis-related infections are initiated during operation by contamination with bacteria-carrying particles from the air as a result of dispersion of skin scales from individuals in the operating room. A small number of infections are caused by hematogenous seeding of bacteria. Glycocalyx, a slime layer produced by bacteria, plays an important role in the pathogenesis of infections, especially in the presence of biomaterial. Clean-air systems in combination with perioperative systemic antibiotics reduce prosthesis-related infections from 3 or 4 per cent to a few per thousand. The use of antibiotic-loaded bone cement is advised in high risk patients although further evaluation is needed. Physical examination of the patient, laboratory tests such as the E.S.R. and C-reactive protein, serial radiograms, isotope scanning techniques and joint aspiration can all help diagnose prosthesis-related infection. However definitive diagnosis is possible only by culturing several samples of material obtained from the interface during revision operation. A perioperative frozen section of interface tissue showing acute (more than 5 leucocytes per field) or severe chronic (more than 50 lymphocytes) inflammation is highly suggestive of sepsis.

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Keywords

Infection Control, Operating Rooms, Postoperative Complications, Joint Prosthesis, Humans, Environment, Controlled, Infections, Anti-Bacterial Agents

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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