Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Peter Holub

Date of original Performance / Presentation

January 2024

Publication Date / Copyright Date

1-1-2024

Abstract

Background: Surgical site infection following subvastus total knee arthroplasty (TKA) is a significant complication, resulting in revision surgery, total joint infection, and prolonged use of pain medications. Problem Statement: The prevention of surgical site infection following subvastus total knee arthroplasty procedures is a significant challenge. There are no specific wound irrigation techniques identified in eliminating Surgical site infections. Most surgeons favor pulse lavage with saline solution combined with polymyxin as the standard of care. Methodology: This retrospective study has been approved by institutional review board of Nova Southeastern University and included 498 de-identified patients who underwent subvastus TKA surgery by a single orthopedic surgeon at Southampton Orthopedic Center from July 2021 to August 2022. The investigator compared the surgeon’s use of two wound irrigation techniques to identify the better irrigation technique. Findings: All post-surgery complications were observed in the polymyxin with saline plus pulse lavage group. There were no joint infections in the polymyxin with saline pulse lavage group and in jet lavage patients. Superficial drainage was noted in five patients in the polymyxin group. Polymyxin with saline pulse lavage plus Irrisept Antimicrobial Wound (jet) Lavage prevented superficial drainage from the surgical site in subvastus TKA patients compared with the saline pulse lavage group. Two patients in the polymyxin group underwent revision surgery due to the loosening of the implants. Conclusions: Polymyxin with saline pulse lavage plus Irrisept Antimicrobial Wound Lavage (jet lavage) irrigation technique had a better outcome in subvastus TKA patients. Further studies are warranted to confirm the findings.

Disciplines

Medicine and Health Sciences

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