Total Knee Arthroplasty Clinical Trial
Official title:
Comparison of Surgical Glove Contamination During Total Knee Arthroplasty Procedure
Total knee arthroplasty post-op surgical site infection rate about 0.5- 5% Pre-operative ,
perioperative and post-operative prevention are importance for reduce surgical site infection
The prevention of surgical-site infections (SSIs) is an integral component of nosocomial
infection control and a major priority in orthopedic surgery.
Surgical wound contamination must be prevented to avoid patient colonisation by
microorganisms during surgery.
Surgical glove changing perioperative can reduce contamination and perforation rate
Orthopedic surgery had found contamination rate about 20-28 % Joint replacement procedure
found contamination rate about 38-67% of all orthopedic surgery 12% of gloves are
contaminated after draping and 24% once patient installation is complete.
We hypothesis that changing surgical glove during total knee arthroplasty can reduce
contamination rate on surgical glove.
Total knee arthroplasty post-op surgical site infection rate about 0.5- 5% Pre-operative ,
perioperative and post-operative prevention are importance for reduce surgical site infection
The prevention of surgical-site infections (SSIs) is an integral component of nosocomial
infection control and a major priority in orthopedic surgery.
Surgical wound contamination must be prevented to avoid patient colonisation by
microorganisms during surgery.
Surgical glove changing perioperative can reduce contamination and perforation rate
Orthopedic surgery had found contamination rate about 20-28 % Joint replacement procedure
found contamination rate about 38-67% of all orthopedic surgery 12% of gloves are
contaminated after draping and 24% once patient installation is complete.
Research question : Does changing surgical glove during total knee arthroplasty can reduce
contamination rate on surgical glove?
Population : Patient who schedule for primary total knee arthroplasty in Srinagarind hospital
Inclusion criteria :Patient who schedule for primary total knee arthroplasty in Srinagarind
hospital
Exclusion criteria :
Patient factor Patient who had previous open knee surgery Patient who have remote infection
at period of surgery for total knee arthroplasty Patient who have lower extremity infection
same side at total knee arthroplasty prior 48 hrs Surgical glove factor gross perforation
Glove changing not include in criteria for study group
Primary outcome :
-Comparison contamination rate of surgical glove in treatment group and control group
Secondary outcome :
-Contamination rate in draping method period and surgical procedure prior to cementation
period in total knee arthroplasty
Study design: a randomized controlled trial
Treatment group glove changing after draping and before cementation glove changing before
cementation Control group
-no glove change
Pre-operative protocal
- iv. Cefazolin 1 hour prior to incision
- skin preparation by Betadine scrub
- Draping including entire limb from thigh to foot
- pre-operative hand wash by Betadine scrub for at least 2 minutes Perioperative protocal
- Operating room include horizontal laminar flow
- Use Ansell GAMMEX latex powdered surgical glove for all glove include in this study
Post-operative protocal
- antibiotic prophylaxis for 24 hours post-op
The five fingertips of each hand were placed on blood agar immediately before each set of
gloves were removed Culture plates were subsequently incubated at 37°C for 48 hours. A single
microbiologist reported the results of the culture. The number of colonies counted as the
number of colony-forming units (CFU) per dish and types of organisms were recorded
identified all bacterial isolates by using Gram stain coagulase oxidase catalase tests. The
degree of contamination was divided into three grades
1. no contamination if there was no growth
2. low contamination where between one and five colonies
3. heavily contaminated if there were more than five colonies
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