Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate

Daniel C. Smith; Richard Maiman; Evan M. Schwechter; Sun Jin Kim; David M. Hirsh

doi:10.1016/j.arth.2015.05.005

Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate

Daniel C. Smith, Richard Maiman, Evan M. Schwechter, Sun Jin Kim, David M. Hirsh

Research output: Contribution to journal › Article › peer-review

41 Scopus citations

Abstract

Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I + D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.

Original language	English
Pages (from-to)	1820-1822
Number of pages	3
Journal	Journal of Arthroplasty
Volume	30
Issue number	10
DOIs	https://doi.org/10.1016/j.arth.2015.05.005
State	Published - 1 Oct 2015
Externally published	Yes

Keywords

Chlorhexidine gluconate
Infection
Irrigation and debridement
MRSA biofilm
Total knee arthroplasty

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10.1016/j.arth.2015.05.005

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title = "Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate",

abstract = "Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I + D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.",

keywords = "Chlorhexidine gluconate, Infection, Irrigation and debridement, MRSA biofilm, Total knee arthroplasty",

author = "Smith, {Daniel C.} and Richard Maiman and Schwechter, {Evan M.} and Kim, {Sun Jin} and Hirsh, {David M.}",

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AU - Smith, Daniel C.

AU - Maiman, Richard

AU - Schwechter, Evan M.

AU - Kim, Sun Jin

AU - Hirsh, David M.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I + D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.

AB - Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period. Significant decrease was noted on all disks before reincubation. Postreincubation, significant decrease in CFUs was found in the 4% and 2% groups. This study demonstrated that I + D of an infected PJI model with 4% CG solution was effective at treating MRSA biofilm at concentrations as low as 2%.

KW - Chlorhexidine gluconate

KW - Infection

KW - Irrigation and debridement

KW - MRSA biofilm

KW - Total knee arthroplasty

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ER -

Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate

Abstract

Keywords

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