Surgical site infection following primary joint replacement at the National Orthopaedic Hospital, Enugu

Abstract

Background: Total joint replacement is increasingly in use for treatment of orthopaedic ailments. Infection following joint replacement surgery can be devastating. Infection rates of 1-2.3% are reported in developed countries. In Nigeria proper theatre facilities, like controlled airflow systems and the use of body exhaust suits, for joint replacement surgeries are not commonplace. Aim: To determine the surgical site infection rates for total joint replacements done in the National Orthopaedic Hospital Enugu and to compare this to what is obtainable in developed countries where proper laminar airflow theatre facilities exist. Materials and Methods: At the National Orthopaedic Hospital Enugu, 33 total joint replacement surgeries were done in 5 years giving an average of 6.6 surgeries per year and the number is increasing. One patient had revision hip arthroplasty and was excluded from the study. Thirty two patients met the inclusion criteria and were recruited into the study. Results: Twenty-three patients had total hip replacement while nine patients had total knee replacement. There were 19 males and 13 females enrolled in the study with a ratio of 1.5:1. The mean age was 57.4years. One patient had superficial incisional surgical site infection giving a surgical site infection rate of 3.1% reported in this study with pseudomonas as the causative organism. Conclusion: It is concluded that these surgeries can be done in the conventional theatres available in Nigeria as the infection rate reported in this study is comparable to what is obtainable in developed countries.