Evidence-Based Protocols for the Prevention and Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty: A Systematic Review
Table 1.
Infection Prevention Protocols for Total HipArthroplasty (THA)
|
| Protocol |
Components |
Reported Outcomes |
|
|
| Antibiotic Prophylaxis [1,15,17,18] |
Cefazolin + gentamicin; timing critical (≥45 min pre-incision) |
SSI reduced from 1.19% to 0.55% |
|
| S. aureus Decolonization [15] |
Nasal swab + decolonization (mupirocin, chlorhexidine) |
Infection rate reduced from 22% to 3% |
|
| Silver-impregnated Dressings [15] |
Antimicrobial dressings reduce acute PJI incidence |
Reduces acute postoperative infection |
|
| ACERTO Protocol [31] |
Shorter fasting, immune nutrition, limited IV fluids |
Reduced LOS and CRP, improved recovery metrics |
|
| Multimodal Surveillance (Passive) [20] |
95% of deep infections detected within 90 days |
Efficient detection of post-discharge infections |
|
| (LAF) [20] |
Airborne contamination control; conflicting evidence for SSI reduction |
No consistent benefit; may increase deep infections |
|
Legend: THA = Total Hip Arthroplasty; PJI = Prosthetic Joint Infection; SSI = Surgical Site Infection; CRP = C-reactive Protein; LOS = Length of Stay; LAF = Laminar Airflow.
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