Surveillance and management strategies to reduce Surgical Site Infection (SSI) in hip and knee joints arthroplasty at a tertiary arthroplasty Unit

Superficial surgical site infection is recognised as a risk factor for deep joint infection in arthroplasty. Deep joint infections cause significant morbidity, adversely affecting a patient’s quality of life and are expensive to manage. Since the advent of arthroplasty there has been a drive towards reducing infection rates and managing risk. Our institution has adopted several strategies to improve our superficial surgical site infection rate including the development of BIU (Bone infection unit) a dedicated infection service, a patient hotline and adjustments to our surgical techniques (utilisation of 2% chlorhexadine for preparation of the skin, special wound protection Aquacel™ dressings, iodine impregnated drapes, and antimicrobial sutures). A review of infection rates before and after implementation of our strategy demonstrates a reported drop in superficial surgical site infection from 6.7% to 3.3%.