Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate

Abstract Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the...

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Bibliographic Details
Published in:The Journal of arthroplasty 2015-10, Vol.30 (10), p.1820-1822
Main Authors: Smith, Daniel C., MD, Maiman, Richard, BA, Schwechter, Evan M., MD, Kim, Sun Jin, MD, Hirsh, David M., MD
Format: Article
Language:English
Subjects:
Anti-Infective Agents - administration & dosage
Bacterial Load
Biofilms
Chlorhexidine - administration & dosage
Chlorhexidine - analogs & derivatives
chlorhexidine gluconate
Debridement - methods
Humans
infection
irrigation and debridement
Joint Prosthesis - microbiology
Methicillin-Resistant Staphylococcus aureus
MRSA biofilm
Orthopedics
Prostheses and Implants
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - surgery
Therapeutic Irrigation - methods
Titanium - chemistry
total knee arthroplasty
Treatment Outcome
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Summary:Abstract Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I + D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2015.05.005