[Prophylactic antibiotherapy in hip arthroplasty. Cohort study]. / Antibioterapia profiláctica en la artroplastia de cadera. Estudio de cohortes.

OBJECTIVE: The surgical site infection is the main cause of nosocomial infection in surgical patients, being antibiotic prophylaxis one of the most important factors for preventing it. This study evaluates adequacy of antibiotic prophylaxis in hip arthroplasty surgery as well as its effect on preventing surgical site infection. METHODS: A prospective cohort study was carried out from January 2011 to December 2016. We assessed the degree of adequacy of antibiotic prophylaxis in hip arthroplasty. Incidence of surgical site infection was studied after a maximum incubation period of 90 days. In order to assess the effect of inadequate prophylaxis on surgical site infection we used the relative risk adjusted with a logistic regression model. RESULTS: We studied 681 patients. Incidence of surgical site infection was 4% (95% CI 2.5-5.5). Antibiotic prophylaxis was administered in 99% of cases, with an overall protocol adequacy of 74%. The main cause of non-compliance was the length of prescription (22.2%; 149 patients). The effect of inadequate prophylaxis on surgical site infection was RRadjusted=0.47; 95%CI 0.19-1.17, (p>0.05). CONCLUSIONS: Adequacy of antibiotic prophylaxis was high. No relationship between prophylaxis adequacy and incidence of surgical site infection was founded. Surveillance allows us to assess surgical site infection and risk factors.

Adecuación de la profilaxis antibiótica en la artroplastia de rodilla e infección del sitio quirúrgico: estudio de cohortes prospectivo / Antibiotic prophylaxis adequacy in knee arthroplasty and surgical wound infection: prospective cohort study

Objetivo. Evaluar el grado de adecuación al protocolo de profilaxis antibiótica en pacientes intervenidos de artroplastia de rodilla y su influencia en la infección quirúrgica. Material y método. Se realizó un estudio de cohortes prospectivo. El grado de adecuación se estudió mediante la comparación de las características de la profilaxis recibida por los pacientes y la estipulada en el protocolo vigente de nuestro hospital. El efecto de la profilaxis en la incidencia de la infección quirúrgica se estimó con el riesgo relativo. Resultados. Se incluyeron 1.749 intervenciones. La incidencia de infección del sitio quirúrgico fue del 1,43% (n=25). La adecuación global al protocolo de profilaxis antibiótica fue del 77,6%. La causa más frecuente de inadecuación al protocolo fue la duración prescrita de los antibióticos de la profilaxis (46,5%). La adecuación de la profilaxis antibiótica no influyó en la infección del sitio quirúrgico (RR=1,15; IC 95%: 0,31-2,99; p>0,05). Discusión. Los programas de vigilancia y control de la infección permiten evaluar factores de riesgo de infección y evaluar medidas de mejora. La vigilancia de las tasas de infección quirúrgica nos permite tomar las medidas oportunas encaminadas a reducir progresivamente su incidencia. Conclusiones. La adecuación de la profilaxis antibiótica fue alta, pero se puede mejorar. No hubo relación entre la adecuación de la profilaxis y la incidencia de infección de la herida quirúrgica en artroplastia de rodilla (AU)

Objective. Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. Material and method. Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year. To assess the effect of prophylaxis non-adequacy on surgical site infection we used the relative risk adjusted with the aid of a logistic regression model. Results. The study covered a total of 1749 patients. Antibiotic prophylaxis was indicated in all patients and administered in 99.8% of cases, with an overall protocol adequacy of 77.6%. The principal cause of non-compliance was the duration of prescription of the antibiotics (46.5%). Cumulative incidence of surgical site infection was 1.43%. No relationship was found between prophylaxis adequacy and surgical infection (RR=1.15; 95% CI: .31-2.99) (P>.05). Discussion. Surveillance and infection control programs enable risk factors of infection and improvement measures to be assessed. Monitoring infection rates enables us to reduce their incidence. Conclusions. Adequacy of antibiotic prophylaxis was high but could be improved. We did not find a relationship between prophylaxis adequacy and surgical site infection rate (AU)

Antibiotic prophylaxis adequacy in knee arthroplasty and surgical wound infection: Prospective cohort study. / Adecuación de la profilaxis antibiótica en la artroplastia de rodilla e infección del sitio quirúrgico: estudio de cohortes prospectivo.

OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. MATERIAL AND METHOD: Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year. To assess the effect of prophylaxis non-adequacy on surgical site infection we used the relative risk adjusted with the aid of a logistic regression model. RESULTS: The study covered a total of 1749 patients. Antibiotic prophylaxis was indicated in all patients and administered in 99.8% of cases, with an overall protocol adequacy of 77.6%. The principal cause of non-compliance was the duration of prescription of the antibiotics (46.5%). Cumulative incidence of surgical site infection was 1.43%. No relationship was found between prophylaxis adequacy and surgical infection (RR=1.15; 95% CI: .31-2.99) (P>.05). DISCUSSION: Surveillance and infection control programs enable risk factors of infection and improvement measures to be assessed. Monitoring infection rates enables us to reduce their incidence. CONCLUSIONS: Adequacy of antibiotic prophylaxis was high but could be improved. We did not find a relationship between prophylaxis adequacy and surgical site infection rate.

Primary angioleiomyoma of the iliac bone: clinical pathological study of one case with flow cytometric DNA content and S-phase fraction analysis.

We report on a primary angioleiomyoma of the right iliac bone in a 28-year-old woman. To our knowledge this is the 16th reported case of a primary leiomyoma of bone, the 9th reported primary osseous angioleiomyoma and the first description of a primary angioleiomyoma located in the iliac bone. The problems of differentiating primary leiomyoma of bone from primary or metastatic leiomyosarcoma of bone are stressed. A literature review of primary leiomyomas of bone is presented.