PREOPERATIVE ASSESSMENT OF SKIN COLONIZATION AND ANTIBIOTIC EFFECTIVENESS IN TOTAL KNEE ARTHROPLASTY

A bacteriologic screening procedure was performed to preoperatively as sess the skin flora of 152 total knee arthroplasty patients and to det ermine the appropriate prophylactic antibiotic and skin-cleansing tech nique. Staphylococcus epidermidis resistant to standard prophylactic a ntibiotics was present in 4.6% of patients, whereas 44% of the patient s had Staphylococcus aureus, which is poorly eradicated by standard cl eansing techniques. Preoperative assessment of skin colonization has d emonstrated that standard preoperative antibiotics and skin-cleansing techniques will not completely eradicate all pathogenic skin bacteria in every case. Preoperative Screening effectively identifies bacterial skin flora and allows for the modification of antibiotic selection an d preoperative cleansing to eradicate resistant bacterial organisms an d thereby decrease the risk of postoperative prosthetic infections.