Abstract
Bacterial growth in relation to suction drains and suction drain tubes following total hip replacements was studied in 105 consecutive patients. All the patients were operated on in a Charnley Howorth Mark II sterile enclosure without walls, but with a body exhaust system and routine antimicrobial prophylaxis. Specimens for culture were taken from the suction drain tip, from inside the suction tube and the incision site. Positive cultures were found in a7 patients; in 20 of them from either the drain tip or the drain track. In 15 patients, the culture revealed coa-gulase-negative staphylococci; in 12 of them from the drain tip or the drain track. Eight patients had a positive culture from the tip of the drain and 16 from the drain track. Four patients had signs of wound hematoma and serous discharge. No patient developed signs of deep infection during the first 12 months after surgery. This study confirms that coagulase-negative staphylococci are the most common single species obtained from cultures after total hip replacement. Routine antimicrobial prophylaxis against coagulase-negative staphylococci might be considered.
Résumé
Les auteurs ont étudié la contamination bactérienne du liquide de drainage et des drains dans une série consécutive de 105 patients opérés d'une prothèse totale de hanche. Tous les patients ont été opérés dans une enceinte stérile de type Charnley Howorth Mark II, avec antibioprophylaxie systématique. Les prélèvements bactériologiques ont été réalisés au niveau de l'extrémité du drain, de sa lumière et au niveau de l'incision cutanée.
Les cultures se sont révélées positives chez 27 patients, dont 21 fois au niveau de l'extrémité ou de la lumière du drain. Un staphylocoque coagulase négative a été retrouvé chez 15 patients, dont 12 fois au niveau de l'extrémité ou de la lumière du drain. Neuf patients avaient une culture positive au niveau de l'extrémité du drain et 16 au niveau de sa lumière. Quatre patients ont développé un hématome et un écoulement séreux. Aucun n'a présenté d'infection profonde pendant les 12 premiers mois après l'intervention.
Cette étude confirme que les staphylocoques coagulase négative sont les germes les plus fréquemment rencontrés sur des prélèvements après prothèse totale de hanche. L'antibioprophylaxie doit en tenir compte.
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Gunterberg, R., Bergmann, B., Brandberg, A. et al. Bacterial growth on drain tips after total hip replacement. A controlled culture method. Eur J Orthop Surg Traumatol 6, 105–108 (1996). https://doi.org/10.1007/BF00568324
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DOI: https://doi.org/10.1007/BF00568324