Vol.60 No.3 May 2012

Prevention of perioperative infection in bone and joints

Kazuhiko Matsushita^1,9), Satoshi Abe^2,9), Tomoo Ishii^3,9), Shiro Kajiyama^4,9), Akihiro Kotani^5,9), Masakatsu Saitoh^6,9), Toshinori Masaoka^7,9) and Toru Suguro^8,9)

¹⁾Department of Orthopaedic Surgery, Kawasaki Municipal Tama Hospital, 1-30-37 Syukugawara, Tama-ku, Kawasaki, Kanagawa, Japan
²⁾Department of Orthopaedic Surgery, Teikyo University School of Medicine
³⁾Department of Orthopaedic Surgery, Endowed Department of Human Resources Development for Community Medicine, Tokyo Medical University Ibaraki Medical Center
⁴⁾Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences
⁵⁾Department of Orthopaedic Surgery, Kyorin University School of Medicine
⁶⁾Department of Orthopaedic Surgery, Sakai Hospital, Kinki University Faculty of Medicine
⁷⁾Department of Orthopedic Surgery, Tokyo Medical University
⁸⁾Department of Orthopaedic Surgery, Toho University
⁹⁾Committee on Clinical Practice Guideline on the Prevention of Surgical Site Infections in Bone and Joint

Abstract

Despite recent advances in developing antimicrobial agents for surgical site infection, many difficulties associated with treatment remain to be solved through prevention. In May 2006, the Japanese Orthopaedic Association developed and published "The Japanese Orthopaedic Association (JOA) Clinical Practice Guideline on the Prevention of Surgical Site Infections in Bone and Joint." Although most issues are explained in the chapter on the adequate use of antimicrobial agents for prophylactic administration, we believe that the choice of antimicrobial agent, the standard dose, the requirement for additional intraoperative doses, administration periods, and the pros and cons of preventive administration of anti-methicillin-resistant Staphylococcus aureus agents need to be studied or re-evaluated. Furthermore, the results of a questionnaire survey answered by the members of the Japanese Society for Study of Bone and Joint Infections revealed that the prophylactic administration period of antimicrobial agents has decreased markedly from the previous period. All external reviewers valued the Guidelines at "recommended" after their publication. However, the participation of non-orthopaedic infectious disease specialists in the Guidelines development group and the need for an external review by experts prior to publication were indicated. Future points that need to be addressed include gathering evidence, evaluating the effectiveness of the Guidelines, taking external reviews into account, and continuous revisions.

Key word

orthopedic surgery, surgical site infection, prophylaxis

Received

January 31, 2012

Accepted

February 6, 2012

Jpn. J. Chemother. 60 (3): 319-326, 2012