Wound drainage after arthroplasty and prediction of acute prosthetic joint infection: prospective data from a multicentre cohort study using a telemonitoring app.

Autor:	Scheper H; Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands., Mahdad R; Department of Orthopaedic Surgery, Alrijne Hospital, Leiderdorp, the Netherlands., Elzer B; Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands., Löwik C; Department of Orthopaedic Surgery, University Medical Centre Groningen, Groningen, the Netherlands., Zijlstra W; Department of Orthopaedic Surgery, Medical Centre Leeuwarden, Leeuwarden, the Netherlands., Gosens T; Department of Orthopaedic Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands., van der Lugt JCT; Department of Orthopaedic Surgery, Reinier Haga Orthopaedic Centre, Zoetermeer, the Netherlands., van der Wal RJP; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands., Poolman RW; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands.; Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., Somford MP; Department of Orthopaedic Surgery, Rijnstate Hospital, Arnhem, the Netherlands., Jutte PC; Department of Orthopaedic Surgery, University Medical Centre Groningen, Groningen, the Netherlands., Bos PK; Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Zwaan RE; Department of Biomedical Data Sciences, Advanced Data Management, Leiden University Medical Centre, Leiden, the Netherlands., Nelissen RGHH; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands., Visser LG; Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands., de Boer MGJ; Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands., The Wound Care App Study Group; A full list of authors appears at the end of the paper.
Jazyk:	angličtina
Zdroj:	Journal of bone and joint infection [J Bone Jt Infect] 2023 Feb 13; Vol. 8 (1), pp. 59-70. Date of Electronic Publication: 2023 Feb 13 (Print Publication: 2023).
DOI:	10.5194/jbji-8-59-2023
Abstrakt:	Background : Differentiation between uncomplicated and complicated postoperative wound drainage after arthroplasty is crucial to prevent unnecessary reoperation. Prospective data about the duration and amount of postoperative wound drainage in patients with and without prosthetic joint infection (PJI) are currently absent. Methods : A multicentre cohort study was conducted to assess the duration and amount of wound drainage in patients after arthroplasty. During 30 postoperative days after arthroplasty, patients recorded their wound status in a previously developed wound care app and graded the amount of wound drainage on a 5-point scale. Data about PJI in the follow-up period were extracted from the patient files. Results : Of the 1019 included patients, 16 patients (1.6 %) developed a PJI. Minor wound drainage decreased from the first to the fourth postoperative week from 50 % to 3 %. Both moderate to severe wound drainage in the third week and newly developed wound drainage in the second week after a week without drainage were strongly associated with PJI (odds ratio (OR) 103.23, 95 % confidence interval (CI) 26.08 to 408.57, OR 80.71, 95 % CI 9.12 to 714.52, respectively). The positive predictive value (PPV) for PJI was 83 % for moderate to heavy wound drainage in the third week. Conclusion : Moderate to heavy wound drainage and persistent wound drainage were strongly associated with PJI. The PPV of wound drainage for PJI was high for moderate to heavy drainage in the third week but was low for drainage in the first week. Therefore, additional parameters are needed to guide the decision to reoperate on patients for suspected acute PJI. Competing Interests: The contact author has declared that none of the authors has any competing interests. (Copyright: © 2023 Henk Scheper et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu