Project Joints: Swiping Away Surgical Infections

They go in hoping surgery will fix their problem, but come out with a potentially deadly dilemma. Every year 300 thousand Americans get a surgical site infection. A recent report found they're the most common healthcare-associated infections in the US.

Now, a new prevention program is helping cut those numbers.

Marilyn Fedor had a bad hip—so she got a new one.

Due to the fact that bacteria that's already on a patient's skin can get into an incision and cause infections doctors started prepping Marilyn for surgery 14 days before the operation. Doctor Brian Tonne says if hip and knee replacement patients get an SSI, typically their implant has to be taken out and they're put on IV antibiotics.

Orthopaedic Traumatologist and Joint Reconstruction Doctor Brian Tonne, MD at the University Of Tennessee Medical Center told Ivanhoe that it, "typically takes six to eight weeks before that joint replacement can then be put back in."

Now "project joints" is reducing that risk. Patients go through an educational class before their hip or knee replacement. Then, "they receive a nasal swab; we can then find out if they carry staph bacteria," Doctor Tonne, MD, explained.

For the final three days before surgery, patients use a special anti-bacterial anti-septic soap.

"You scrub your whole body down from the neck down and then they said to do your leg, my bad leg for three minutes," Hip Replacement Patient Marilyn Fedor, told Ivanhoe.

And clippers are used at the surgical site instead of razors, to help keep bacteria out of the body.

The University Of Tennessee Medical Center's infection rate for knee and hip replacements was almost two-percent before project joints. Now, "it has dropped to approximately point-five percent," Doctor Tonne said.

Project joints is currently in hospitals in eight states and is expanding to facilities in five more states. The doctor says right now, the program is only being used for patients getting hip and knee replacements, but the goal is to use it in other joint replacements and orthopedic procedures.

SURGICAL SITE INFECTIONS:  After surgery, some people can develop infections at the site where the surgery took place.  These infections are known as surgical site infections (SSI).   SSI's can be superficial infections, affecting the skin around the surgery site, or can be more serious and dangerous infections affecting the implanted material, tissues, or organs near the site.  If the infection is serious enough, it can spread throughout the body, making it potentially life-threatening. (Source: http://www.cdc.gov/HAI/ssi/faq_ssi.html

WHAT TO LOOK OUT FOR:  If you have just had surgery, make sure to keep the site clean.  There are symptoms which may point toward an infection, which include:

  • Redness around the site
  • Cloudy fluid draining from the site
  • Fever

If you experience any of these symptoms after surgery, tell your doctor immediately. (Source: http://www.cdc.gov/HAI/ssi/faq_ssi.html)

PRECAUTIONS: You, your doctor, and your friends can help prevent an SSI from occurring.  Taking precautions like not smoking, avoiding the use of a razor around the surgery site, and telling your doctor about any health issue you have can all decrease your chances of developing an SSI.  Your doctor should also avoid shaving the area with a razor, but also should be properly washed and cleaned before and after surgery.  Asking your friends and caregivers to wash and disinfect their hands before and after seeing you can help your chances of avoiding an infection.  Also, do not let anyone but you, your doctor, or a trained caregiver touch or clean your wound.  (Source: http://www.cdc.gov/HAI/ssi/faq_ssi.html)

TREATING AN SSI:  If you do develop an SSI, antibiotics are the most common treatment.  If the infection is serious enough, then surgery may be the only option.  Doctors can go back into the surgery site and manually clean up some of the infected material.  Sometimes even the implanted material has to be removed in order for the infection to clear up.  Doctors are now stepping up their precautionary measures in an effort to avoid treatment.  Programs like Project JOINTS are active in eight states: Arkansas, New York, Maryland, Michigan, Tennessee, Wisconsin, Colorado, and Oregon. (Source: www.ihi.org/offerings/Initiatives/ProjectJOINTS/Pages/ExemplarHospitals.aspx)

For More Information, Contact:

Brian Tonne, MD

Orthopaedic Traumatologist and Joint Reconstruction

University Orthopaedic Surgeons

University of Tennessee Medical Center