February 5, 2019
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Prosthetic Joint Infection: Diagnosis & Management

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Can UV-C Air Decontamination Cut Periprosthetic Join Infection?
Can an air decontamination system effectively reduce periprosthetic joint infections (PJI) by attacking airborne bacterial onslaughts? A team of Tennessee-based researchers designed a retrospective observational study to try to answer that question. Their study, “The Impact of Supplemental Intraoperative Air Decontamination on the Outcome of Total Joint Arthroplasty: A Pilot Analysis,” appears in the December 7, 2018 edition of The Journal of Arthroplasty. Co-author Charles Edminston, Jr., Ph.D., Emeritus Professor of Surgery, Medical College of Wisconsin and Professor, Vanderbilt University School of Medicine, Nashville, Tennessee, told OTW, “We undertook this work because of our institutional concern for reducing the risk of total joint infection which is responsible for significant patient morbidity and potential mortality in high risk patients.”

Potential Remains for Bacteriophage Therapy, Despite Failure of Burn Infection Trial 
Newly published research finds both potential and problems with the concept of using bacteriophages to treat infected burn wounds. Investigators in France recently evaluated whether a cocktail of bacteriophages might be a suitable replacement for traditional therapies in patients whose burn wounds were infected with Pseudomonas aeruginosa. Wound infections are a leading cause of sepsis in burn victims, but the bacteria are often resistant to multiple drugs. The use of bacteriophages—natural bacterial viruses—has been suggested as a way to counter the problem of drug resistance.
How to Cut 1 Hospital Day in Revision TKA/THA Cases
Surgeons from Florida have come up with some specific suggestions as to how their colleagues can improve treatment metrics for arthroplasty revision patients. Their work, “Bundled Payment “Creep”: Institutional Redesign for Primary Arthroplasty Positively Affects Revision Arthroplasty,” was published in the February 2019 edition of The Journal of Arthroplasty. Chancellor Gray, M.D., an orthopedic surgeon at the University of Florida College of Medicine in Gainesville and co-author on the work, told OTW, “We found that the overall environment and culture of care in our health system was improving, favoring increased value for our total joint arthroplasty [TJA] patients, in the wake of our Comprehensive Care for Joint Replacement (CJR) inspired redesign of our total joint program."

Thermal Imaging Offers Better Way to Assess Burns
Burns cause approximately 180,00 deaths every year. A new method may offer a better way to predict the best treatment. When a patient arrives at the emergency room with a burn, doctors do a clinical inspection to assess both the severity of the lesion in relation to the affected area of the body and the injury’s depth (first, second or third-degree burns). The surgical team then makes a decision—based on this assessment and other considerations including bleeding and the extent of the damage—on how best to manage the patient’s care. However, because a wound can change in the days following the initial injury, using clinical inspection alone is inaccurate in 30 to 50 percent of cases.

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