The effectiveness of preoperative colon cleansing on post-operative surgical site infection after hip hemiarthroplasty
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ORIGINAL ARTICLE
The effectiveness of preoperative colon cleansing on post‑operative surgical site infection after hip hemiarthroplasty Sefa Giray Batibay1,4 · Salih Soylemez2 · İsmail Türkmen3 · Yusuf Bayram3 · Savas Camur3 Received: 12 September 2018 / Accepted: 29 March 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Aim This study aimed to evaluate the effectiveness of prophylactic mechanical bowel preparation in elderly patients undergoing hip hemiarthroplasty in a single training institution over a period of 2 years. Patients and methods The study was conducted in a prospective-randomised manner. All patients, who underwent primary hip hemiarthroplasty for femoral neck fracture in our institution between 20 February 2015 and 29 December 2016, were included. B.T. Enema (sodium dihydrogen phosphate + disodium hydrogen phosphate) 135 ml (Yenisehir Laboratory, Ankara, Turkey) was used for colon cleansing. Results Ninety-five patients were followed up for at least 1 year after surgery (16.3 ± 4.2 months). Of these, 46 were in the enema group and 49 were in the control group. Demographic and clinical characteristics of patients were similar in both groups (p > 0.05). Infection rates between the two groups were not significantly different (p > 0.05). In addition, ASA, age, sex, presence of diabetes mellitus, duration of surgery, time to surgery, ambulation status and blood count did not have a significant effect on surgical site infections (p > 0.05). However, all infections in the enema group were monobacterial and were successfully treated, whereas two of the four infections in the control group were polymicrobial and could not be successfully treated. Conclusion Although preoperative colon cleansing did not reduce the overall incidence of post-operative infections, our study suggested that it may reduce polymicrobial infections after hip hemiarthroplasty. Polymicrobial infections after hip hemiarthroplasty seem to have worse prognosis. Therefore, the effectiveness of preoperative colon cleansing in remediating such infections must be investigated in a larger number of patients. Keywords Hip hemiarthroplasty · Infection · Colon cleansing · Hip fracture · Hospital care
Introduction Over the past century, life expectancy has dramatically increased with people living well into their 90s instead of the 70s [1]. However, this increase has introduced problems such as an increase in hip fractures in elderly patients, * Sefa Giray Batibay [email protected] 1
Derince Education and Research Hospital, Department of Orthopedics and Trauma, SB University, Kocaeli, Turkey
2
Istanbul Fatih Sultan Mehmet Education and Research Hospital, Department of Orthopaedics and Trauma, SB University, Istanbul, Turkey
3
Umraniye Education and Research Hospital, Department of Orthopedics and Trauma, SB University, Istanbul, Turkey
4
Kosuyolu/Istanbul, Turkey
necessitating surgical procedures to repair these fractures. Hemiarthroplasty—the most commonly used procedure— possesses the ris
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