CME OnDemand: 2022 AOFAS Annual Meeting-Surgical Site Infection after Foot and Ankle Surgery: A Retrospective Analysis of Incidence using a Low Concentration Chlorhexidine Gluconate (CHG) 0.05% in Sterile Water

Surgical Site Infection after Foot and Ankle Surgery: A Retrospective Analysis of Incidence using a Low Concentration Chlorhexidine Gluconate (CHG) 0.05% in Sterile Water

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This study retrospectively analyzed the use of low concentration Chlorhexidine Gluconate (CHG) irrigation for infection prevention after foot and ankle surgery. Surgical site infections (SSIs) in foot and ankle surgery have higher rates compared to other surgeries and can lead to increased hospital stays, re-operations, and readmission rates. The study aimed to assess the incidence of SSIs in patients who underwent foot and ankle surgery with intraoperative lavage using low concentration CHG. <br /><br />The study included elective and non-elective procedures at a single institution from September 2020 to October 2021. Cases with concurrent use of topical vancomycin powder or postoperative prophylactic antibiotics were excluded. The primary outcome was SSI, and the secondary outcomes were complications like erythema, delayed wound healing, dehiscence, and reoperations. <br /><br />The results showed that out of 73 patients, there were 6 SSIs, with 2 being superficial and 4 being deep. Four patients required reoperations for deep SSIs caused by different bacteria. Interestingly, 3 out of the 4 patients with deep SSIs had a previous history of orthopedic SSIs. <br /><br />The limitations of the study include its retrospective design, short-term follow-up, lack of comparative outcome data, and the potential bias of one of the authors being a board member of Irrimax Corporation. The study concludes that low concentration CHG irrigation may be useful in mitigating postoperative SSIs in patients without a history of previous orthopedic SSIs. However, patients with a history of previous orthopedic SSIs may require additional measures to prevent SSIs. The study also suggests the need for additional comparative studies.

Asset Subtitle

Calvin J. Rushing, DPM

Keywords

low concentration Chlorhexidine Gluconate

infection prevention

foot and ankle surgery

surgical site infections

hospital stays

re-operations

readmission rates

intraoperative lavage

elective procedures

non-elective procedures