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Health May 2013

Aid for Age

Stopping Surgical Infections During Joint Replacement Procedures

By Tait Trussell

Surgical-site infections can come from operating room staff doctors or nurses, from contamination of the prosthetic joint during the surgical procedure, or from pathogens in the patient’s body. The patient may have pathogens on his skin or in his or her mucous membrane.

They call it Project Joints. It’s a procedure now in hospitals in 10 states that has been successful in reducing costly infections in hip and knee replacements – procedures that take place at least one million times a year.

At least 50,000 people a year die from hospital-acquired infections. To reduce mortality and expenses, Project Joints involves a multi-step process.

Surgical-site infections can come from operating room staff doctors or nurses, from contamination of the prosthetic joint during the surgical procedure, or from pathogens in the patient’s body. The patient may have pathogens on his skin or in his or her mucous membrane.

If infection occurs during the operation, it calls for more surgery. It also means severe pain, extended use of antibiotics and in some cases, even amputation.

As our population ages, we can expect a huge increase in hip and knee replacements. Project Joints grew out of new financial penalties from Medicare for preventable hospital infections and concern about hospital infections shared by medical personnel. The government pays for the safety procedures.

When infection does occur in a hip replacement, for example, it can add $100,000 to the hospital bill, medical experts say. Not to mention the possibility of malpractice suits.

Project Joints uses many means of reducing possible infection. Instead of shaving hair in the location to be operated on, it uses clippers. Shaving could cut the skin, opening the door to bacteria, which could get into the blood stream. The skin is prepared with an alcohol antiseptic.

But that’s only the beginning. The patient, several days before surgery, must have a nasal swab to be tested for bacteria, take a class about preventing infection, shower for three days with a special soap, and sleep on clean sheets before the operation.

At Canton-Potsdam Hospital in Potsdam, N.Y., they had an infection prevention program six years ago, which it expanded to cover all the steps in Project Joints. Since then it has not had a hip or knee surgery infection.

As part of the Project Joints preparation for patients, they are asked to view a video showing a patient who had knee surgery and contracted an infection. It required 16 follow-up surgeries before she was told by doctors there was nothing else they could do but amputate her leg above the knee.

Project Joints has gone a long way to remove this drastic step.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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