Greenwich Hospital and the ONS Foundation for Clinical Research and Education (ONSF) conducted research on surgical site infections, where they examined why a certain bacteria is so common in post-surgical shoulder infections.
The research project called Understanding and Preventing Surgical Site Infection was awarded second place at the recent meeting of the American Orthopedic Society for Sports Medicine (AOSSM).
The research was conducted with 57 patients who were scheduled to undergo arthroscopic shoulder surgery to implant prosthetic shoulder joint structures or to repair injuries such as rotator cuff tears.
The surgical research team collected pre- and post-surgery swabs and tissue samples, which were analysed to evaluate the potential for post-operative infection since such complications could eventually result in chronic pain and in some cases, additional surgeries.
According to Dr. Sethi, MD, Orthopaedic Surgeon, "The bacterium (Proprionibacter Acnes) most commonly attributed to shoulder infection, is a very unusual organism. Until recently, however, it was not properly recognised because it was so difficult to identify."
Timothy Green, MD and President of ONSF, Katie Vadasdi, MD, Director of the ONS-Women's Sports Medicine Center and James Sabetta, MD, GH Infectious Disease Specialist, also participated in this research.
The primary objective of the team was to understand why this bacterium is so common in post-surgical shoulder infections. They also wanted to determine where and how the exposure happens and the best strategies to control it. Their research showed that Proprionibacter Acnes, which resides deep within the skin pores, is the bacterium that resists the most stringent skin sterilisation procedures that are undertaken prior to surgery.
The surgical team recommends that current procedures for pre-surgical skin protection need to be evaluated and revised. They also point out that there is a chance that intraoperative exposure can occur if instruments or prosthetic devices come in contact with the patient's skin.
Dr. Sethi highlights that since the field of shoulder surgery and shoulder replacement is growing, the risk of developing shoulder infection is also increasing. Such infections can result in devastating complications and thus there is a need to develop a universal measure to minimise post-surgical infection.
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