Staph Infection Heightens Risk of Surgical Complications
Infection after joint replacement surgery is a terrible complication that often results in subsequent surgeries with extended morbidity and rehabilitation. The possibility of infection after joint replacement depends to some degree on the patient’s immune capabilities, with the incidence ranging from 1.5 to-6% over a lifetime.
One of the leading pre-operative risk factors in orthopedic patients is the presence of Staphylococcus aureus (S. aureus), or staph, on the skin or nasal cavity. Most postoperative infections after joint replacement are the result of bacteria from the patient’s skin falling into the wound during surgery. In most cases, the immune system is able to eliminate those bacteria, but staph carriers are two to ten times more likely to face infection.
Pre-operative skin washing at home, skin scrubbing in the operating room, and intraoperative surgical irrigation and antibiotics help minimize this risk. Patients with staph chronically growing on their skin are at higher risk due to the aggressive nature of this bacteria and the heightened risk of wound infection. On average, 18-25% of patients will have staph on their skin chronically, and of this group, approximately 11% have a strain resistant to antibiotics.
A recent study done at NYU Langone Medical Center analyzed 13,828 orthopedic patients between 2009 and 2016. In this study, patients were tested preoperatively for the presence of S. aureus, with 18% testing positive for colonization. The researchers also found that 4.35% of the colonized patients developed surgical site infections (SSIs) after surgery while only 2.39% of non-colonized patient’s developed SSIs postoperatively. Specifically, patients who had undergone total knee replacement surgeries were 380% more likely to develop a postoperative infection if the patient was colonized with S. aureus prior to the procedure.
This information points to the importance of understanding who is at higher risk of a post-operative infection. Developing methods to minimize this prior to surgery also helps combat readmission, revision surgery, longer hospital stays, and increased medical bills.
Questions about joint replacement surgery? Concerned about your orthopedic health or interested in taking steps to protect it in the future? Dr. Stickney is a Kirkland orthopedic surgeon who can help find the best surgical and nonsurgical options for you. Contact his office for an appointment today.