To undergo an orthopedic surgical operation so as to obtain more comfort and less pain is also to accept the risks inherent to any surgical procedure. Among the risks entailed, the risk of infection is the one which most patients worry about.
The improvement of techniques, the shortening of the duration of operations, a better knowledge of the microbial flora and a better effectiveness of the antibiotics therapy have significantly reduced the risks of infection in orthopedic surgery. Can the surgeon and the patient contribute even more to reducing the frequency and the seriousness of infectious complications?
An example of the surgeon’s behavior at the Darcy Orthopedic Practice to reduce the risks of infection:
- Surgical arthroscopy, without incision and on a limited stay of less than a day.
- Use of a ‘custom-pack’: a a single-use pack of tools sterilized in a laboratory and containing practically all the tools necessary to the surgical procedure performed. This method reduces the risk of mistakes of asepsis when the nurse hands out to the surgeon the items required for performing the operation (stitches, dressings, aspiring cannula, electrical bistoury).
- Surgery performed via very short incisions (Mini-Invasive Surgery): this technique which is made possible by a very well suited tooling is used for prosthetic and ligament surgery. Cutting short ways of access without lifting off skin very often permits to do without any pos-op drainage.
- Absence of systematic change of post-op dressing since the dressing is supposed to be sterile when it is applied in the operating theatre. If the latter remains dry, without any inflammatory sign after the operation, renewing it is not a necessity, reducing thus the risk of secondary contamination as long as the skin healing is not completed.
How can the patient act preventively to securise his or her operation?
We make a reminder of some requirements or common-sense behavior to be respected in the days preceding the operation so as to reduce the risks of infection:
- To eradicate any infected site near the site of the operation before the procedure. To check all absence of skin contamination (boil, over-infected spot, whitlow).
- To make sure there is no tooth infection, especially for an operation aiming at setting an articular prosthesis.
- Heavy smoking increases considerably the infectious risk because of the vascular troubles induced by tobacco.
- Diabetes, venous or artery insufficiency are factors that increase the risks of infection by delaying scar-healing.
- A superficial cutaneous lesion over the site of the operation is also a well-known factor of risk of an infection.
- For ambulatory surgery, if the patient is asked to shave the day before the operation, it is absolutely necessary to perform this shaving in a non-aggressive way, without any cut, irritation nor abrasion of the dermis.
- A systematic bacteriological check-up of the urines will be performed several days before the operation in case of a prosthetic implant on the lower limb. In the case of a joint prosthetic implant, it is necessary to be sure the urines are sterile.