Postoperative Infection Rates After Total Ankle Arthroplasty: A Comparison With and Without the Use of a Surgical Helmet System.

Abstract

Following total joint arthroplasty, surgical site infections (SSI) and periprosthetic joint infections (PJI) are associated with increased patient morbidity and healthcare utilization. Current positive-pressure surgical sterile helmet system (SHS) were developed as a feasible, useful version of the body exhaust system.The use of SHS has not yet been proven to decrease infection rates in the orthopedic literature. The primary purpose of this study is to compare the infection rates between patients who underwent total ankle arthroplasty (TAA) with a surgical team wearing SHS versus without SHS.A retrospective chart review in patients undergoing primary TAA with the surgeon wearing SHS (Group 1) or standard surgical attire (Group 2) was conducted. The primary outcome was postoperative SSI and PJI. The rate of wound complications, revision rates, and associated procedures were also analyzed. We identified 109 patients in Group 1 and 151 patients in Group 2. The rate of SSI was 12.8% in Group 1 and 14.6% in Group 2 (p = .411). The rate of PJI was 0.92% in Group 1 and 2.6% in Group 2 (p = .411). There was no difference in revision rates between the two groups. This study suggests that SHS does not appear to protect against postoperative SSI or PJI after TAA. Conversely, we did not find a higher infection rate compared to standard surgical attire despite recent in-vitro studies suggesting SHS as a source of wound contamination. The utility of SHS does not appear to influence the prevalence of postoperative SSI or PJI.

• Authors: Eric So, Christopher A Juels, Chad Seidenstricker, Robert Walker, Ryan T Scott
• Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2022 Jul-Aug Vol. 61 Issue 4 Pg. 802-806 ISSN: 1542-2224 [Electronic] United States
• PMID: 34974981 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Ankle
• Arthritis, Infectious
• Arthroplasty, Replacement, Ankle (adverse effects)
• Arthroplasty, Replacement, Hip (adverse effects)
• Arthroplasty, Replacement, Knee
• Head Protective Devices (adverse effects)
• Humans
• Prosthesis-Related Infections (epidemiology, etiology, prevention & control)
• Retrospective Studies
• Surgical Wound Infection (epidemiology, etiology)