       Document 0415
 DOCN  M9610415
 TI    The prevention of orthopaedic implant and vascular graft infections.
 DT    9601
 AU    Strachan CJ; Department of Surgery, Royal Sussex County Hospital,
       Brighton,; UK.
 SO    J Hosp Infect. 1995 Jun;30 Suppl:54-63. Unique Identifier : AIDSLINE
       MED/96035332
 AB    The infection rate for any surgical prosthesis insertion should be less
       than 1% in the first postoperative year. If infection occurs the
       patients will lose their new found mobility, lose their independence, be
       hospitalized with sepsis, both local and systemic, and perhaps die.
       Preoperative and intraoperative measures to prevent infection are well
       established in orthopaedic surgery but less scientifically applied in
       peripheral vascular surgery. In both specialties the problem of late
       infection has promoted research on the protection of the peri-prosthetic
       environment against both bacteria and biofilm. In orthopaedics, the
       incorporation of various antibiotics into bone cement is well accepted
       in revision surgery, but still debated for the primary operation.
       On-going research on bioresorbable ceramics and the incorporation of
       antibiotics more effective against coagulase-negative staphylococci
       should eventually counter late infections. As HIV-positive patients
       increasingly present with sepsis around implanted prostheses this need
       will increase. In vascular surgery as the risk factors for biomaterial
       infection are better understood, new generations of protein-sealed
       grafts are permitting ionically compatible antibiotic coatings. Large
       well-designed clinical trials have begun and are needed to confirm the
       forecast of improved long-term clinical outcomes.
 DE    Antibiotics/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE  Blood Vessel
       Prosthesis/*ADVERSE EFFECTS  Human  Implants, Artificial/*ADVERSE
       EFFECTS  Orthopedics  Risk Factors  Staphylococcal
       Infections/MICROBIOLOGY/*PREVENTION & CONTROL  Staphylococcus
       epidermidis  Surgical Wound Infection/MICROBIOLOGY/*PREVENTION & CONTROL
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

