Effect of multidimensional intervention to reduce surgical site infection rate after knee and hip arthroplasty

Germs. 2021 Mar 15;11(1):10-22. doi: 10.18683/germs.2021.1236. eCollection 2021 Mar.


INTRODUCTION: Prevention strategies are critical to reduce infection rates in joint arthroplasty. This study aimed to investigate the effectiveness of a set of evidence-based practices to reduce surgical site infection (SSI) rates after knee and hip arthroplasty (HPRO & KPRO).

METHODS: A quasi-experimental study design (comparing pre- and post-intervention phases) was applied. Interventions were selected, adapted, and implemented in knee and hip arthroplasty procedures as a prospective practice. They consisted of 13 processes throughout the surgical encounter, including preoperative, intraoperative, and postoperative elements.

RESULTS: Regarding hip arthroplasty procedures, the overall SSI rate during the pre-intervention period was 11.9%, which was reduced significantly to 5.1% (57% reduction) in the intervention period (p=0.042). For knee arthroplasty procedures, the overall baseline SSI rate during the pre-intervention period was 2.7%, which was reduced to 2.0% (26% reduction) in the intervention period. However, this reduction was not statistically significant (p=0.561). Combined methicillin-resistant Staphylococcus aureus (MRSA) screening with appropriate decolonization and targeted prophylaxis were associated with a 50% reduction in SSI caused by MRSA in knee arthroplasty.

CONCLUSIONS: The implementation of multidimensional evidence-based practices was associated with a reduction in SSI following knee and hip arthroplasties.

PMID:33898337 | PMC:PMC8057843 | DOI:10.18683/germs.2021.1236