Examining the Efficacy of Drain Tip Cultures in Predicting Postoperative Surgical Site Infections in Hip Arthroplasty: A 15-Year Retrospective Study.

bipolar hip arthroplasty (bha) drain tip culture postsurgical infection primary hip replacement prognostic value revision hip arthroplasty surgical drain surgical site infection total hip arthroplasty (tha)

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Oct 2023
Historique:
accepted: 28 09 2023
medline: 6 11 2023
pubmed: 6 11 2023
entrez: 6 11 2023
Statut: epublish

Résumé

Background Postoperative surgical site infections (SSIs) are a significant complication of surgical procedures, leading to increased morbidity, prolonged hospital stays, and substantial healthcare costs; however, the use of drain tip cultures to diagnose SSIs in patients is controversial. The objective of this study was to evaluate the efficacy of drain tip cultures for the prediction of postoperative SSIs in patients recovering from hip arthroplasty. Methodology The data were collected from 1204 patients who underwent hip arthroplasty procedures over 15 years, and statistical analysis was performed to evaluate the diagnostic value of drain tip culture in determining surgical site infection. We also used these data to evaluate whether preexisting conditions such as hypertension or diabetes affected the probability of a patient getting an SSI. Results Drain tip cultures were positive in 12 of 1,112 cases of primary hip arthroplasty, but only one of these 12 patients was ultimately diagnosed with an SSI (sensitivity, 12.5%; specificity, 99.0%; p = 0.0834). Results from postoperative drain tip cultures performed in patients undergoing revision arthroplasty included two false positives and three false negatives; interestingly, no true positives were detected in any of the revision arthroplasty cases we evaluated (sensitivity, 0%; specificity, 97.8%; p = 0.9355). Conclusion Our results indicate that drain tip cultures have no statistically significant predictive value for the diagnosis of postoperative SSIs and thus should not be used as a primary diagnostic or predictive tool for SSIs. We recommend exploring other diagnostic tools for the postoperative diagnosis of SSIs. Standardized guidelines should therefore be established to improve the predictive value of the different methods.

Identifiants

pubmed: 37927684
doi: 10.7759/cureus.46395
pmc: PMC10620546
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e46395

Informations de copyright

Copyright © 2023, Toga et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Akira Toga (A)

Department of Orthopaedic Surgery, Edogawa Hospital, Tokyo, JPN.
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, JPN.

Ayush Balaji (A)

Department of Orthopaedic Surgery, Edogawa Hospital, Tokyo, JPN.
Medicine, Hull York Medical School, York, GBR.

Osamu Hemmi (O)

Keiyu Artificial Joint Center, Edogawa Hospital, Tokyo, JPN.

Ken Ishii (K)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, JPN.
Keiyu Artificial Joint Center, Edogawa Hospital, Tokyo, JPN.
Spine Surgery, Society for Minimally Invasive Spinal Treatment (MIST), Tokyo, JPN.

Shigeyuki Tokunaga (S)

Department of Orthopedic Surgery, Edogawa Hospital, Tokyo, JPN.

Shojiro Katoh (S)

Department of Orthopaedic Surgery, Edogawa Hospital, Tokyo, JPN.

Ryoichi Izumida (R)

Keiyu Artificial Joint Center, Edogawa Hospital, Tokyo, JPN.

Classifications MeSH