What Patients Need To Know About Total Joint Infections – Part Two

 In General

What Patients Need To Know About Total Joint Infections – Part Two

I would try to work on being as fit and healthy as possible and if surgery is offered try to actively participate. After surgery, I would make sure to keep the wound clean. Healthy skin closes in about three days. If there is drainage and the skin is not closed, I would be meticulous about dressing changes and as how to do it. When others change the dressing, I would observe the professionals to make sure they do not introduce more bacteria. I have my patients start dressing changes at three days and clean the skin with Chlorhexadine/Hibiclens even after taking a shower. Studies tend to show whole body Chlorhexadine cleaning for a few days prior to surgery helps lower the overall bacterial count. You can get Chlorhexadine wipes on Amazon. We always treat the nares/nose with Iodine swabs the day of surgery and it wouldn’t hurt to do so before surgery of any type. Those swabs are also available on Amazon. It is not the everyday iodine, but a swab specifically formulated for that purpose made by 3M.

There are a whole host of things the hospital, surgery team, nurses and your surgeon can and hopefully will do to decrease risk of infection. This article is primarily focusing on what the patient can do and what to think about if an infection occurs. The principles are, for the most part, the same for any surgery. We live in a time where we have antibiotics in our food and doctors over prescribe antibiotics and these trends combined with others makes us have more virulent bacteria like MRSA (methicillin resistant staff aureus). The food antibiotics has been going on for a long time. Doctors have more gradually become more enabling. They prescribe antibiotics because the patient wants them to even when, from a scientific perspective, to the best of their knowledge antibiotics are not indicated. So, statistically, the trend that is more recent is the change in the general health of the population. I would hope that all doctors and all patients want to be healthy and have successful surgeries.

Total joint arthroplasty (joint replacement) and consequent infections and revisions are growing at an astronomical rate. Many of the practices that prevent infection are the same ones that prevent the need for arthroplasty. Obesity, for example, doubles the risk of infection. Normal walking puts four times body weight on a knee. Cartilage has to be used to be healthy but it does not respond well to chronic overloading. Notably, we did not have arthroplasty as an option until about a half century ago. It is growing at a rate such that Orthopedics costs, along with cancer, are the top two that use our federal monies. Entitlements consume roughly two thirds of the federal/state budget and are growing. The point is whether for economic reasons or general health and well-being, understanding some of the factors involved may help us to make good decisions.

Sincerely,
Dr T Scott McGee