Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty.
Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, and Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today 2017; 3(4):294-297
Background: Surgical site irrigation during total hip (THA) and total knee (TKA) arthroplasty is a routine practice among orthopaedic surgeons to prevent periprosthetic joint infection. The purpose of this study was to evaluate the effect of chlorhexidine gluconate (CHG) irrigation on infection rates following THA and TKA.
Methods: Arthroplasties performed before September 2014 served as controls. THA performed before September 2014 (N = 253) underwent intraoperative irrigation with 0.9% saline followed by a 2-minute soak with
Results: In this 2:1 comparison of consecutive patients, there were no differences in patient demographics between the 2 groups. No difference was noted in wound healing concerns subjectively, and no statistically significant association in nonsurgical site infections, superficial surgical site infection, and deep surgical site infection rates between the 2 groups (nonsurgical site infections [THA:
Conclusions: We were unable to discern a difference in infection rates between chlorhexidine irrigation and our prior protocols using dilute Betadine for THA and 0.9% saline for TKA. The theoretic advantages of dilute CHG retention during closure appear to be safe without infectious concerns.