Microbial Growth in Operative Splash Basins During Total Joint Arthroplasty
Study Details
Study Description
Brief Summary
The usage of splash basins in the setting of total knee arthroplasty and total hip arthroplasty presents a risk of contamination and subsequent periprosthetic joint infection. Previous studies have investigated the efficacy of multiple antimicrobial irrigants for preventing periprosthetic joint infection, but the results are varied.
Despite several noteworthy studies on the appropriate usage of different antiseptic solutions in surgical splash basins, the current literature has several limitations. First, there are no head-to-head clinical trials comparing betadine and chlorhexidine gluconate (CHG) usage with relation to periprosthetic joint infection and splash basin contamination rates. Second, the in vitro studies directly cultured splash basin antiseptic solutions rather than culturing surgical instruments.
The objective of this study is to compare the microbial contamination rate of total joint arthroplasty instruments that have been placed in surgical splash basins filled with either sterile water, 3.5% betadine, or 0.05% CHG. The overall purpose of the study is to investigate the efficacy of 0.05% CHG and determine if it is an appropriate solution to use in surgical splash basins for joint replacement surgeries.
A prospective clinical trial will be conducted. Patients treated at the Keck Hospital of USC or USC Verdugo Hills Hospital for primary total hip or total knee arthroplasty will be screened for inclusion in our study. All primary surgeries will be performed according to the preferences of the operating surgeon. No deviations from standard surgical care will be made based on inclusion in this study. However, prior to surgery, patients who elect to participate will be randomized to one of three groups: (1) sterile water, (2) 3.5% betadine, or (3) 0.05% CHG.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Sterile Water
|
Other: Sterile Water
1L of sterile water used in surgical splash basins during total joint arthroplasty to clean surgical instrumentation.
|
| Experimental: 3.5% betadine
|
Other: 3.5% Betadine
1L of 3.5% betadine used in surgical splash basins during total joint arthroplasty to clean surgical instrumentation.
|
| Experimental: 0.05% chlorhexidine gluconate
|
Other: 0.05% Chlorhexidine Gluconate
1L of clorhexidine gluconate used in surgical splash basins during total joint arthroplasty to clean surgical instrumentation.
|
Outcome Measures
Primary Outcome Measures
- Microbial Contamination Rate of Surgical Instruments [14 days]
Microbial contamination rate of total joint arthroplasty instruments that have been placed in surgical splash basins filled with either sterile water, 3.5% betadine, or 0.05% CHG
Secondary Outcome Measures
- 90-Day Wound Complication [90 days]
Differences in 90-day wound complications and 90-day periprosthetic joint infections between the sterile water, 3.5% betadine, and 0.05% CHG surgical splash basin groups
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients presenting to Keck Hospital of USC or USC Verdugo Hills Hospital for primary total knee arthroplasty or total hip arthroplasty.
Exclusion Criteria:
-
Age < 18 years.
-
History of previous total hip arthroplasty or total knee arthroplasty.
-
History of previous knee or hip joint infection.
-
History of previous allergic reaction to chlorhexidine.
-
Known allergy to iodine or shellfish.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Keck School of Medicine of USC | Los Angeles | California | United States | 90033 |
Sponsors and Collaborators
- University of Southern California
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Anto B, McCabe J, Kelly S, Morris S, Rynn L, Corbett-Feeney G. Splash basin bacterial contamination during elective arthroplasty. J Infect. 2006 Mar;52(3):231-2. Epub 2005 Dec 28.
- Baird RA, Nickel FR, Thrupp LD, Rucker S, Hawkins B. Splash basin contamination in orthopaedic surgery. Clin Orthop Relat Res. 1984 Jul-Aug;(187):129-33.
- Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today. 2017 May 12;3(4):294-297. doi: 10.1016/j.artd.2017.03.005. eCollection 2017 Dec.
- HS-19-01005