CORA ABSTRACT #IV - 3

EFFECTIVENESS OF BULB VERSUS PULSE IRRIGATION FOR THE REMOVAL OF BACTERIA FROM PROSTHETIC SURFACES

T. Turgeon

W. Dust

S. Sanche

K. Mochoruk

Tremendous morbidity and costs are associated with infections following total joint arthroplasty. To reduce infection risk, some surgeons use pulse irrigation prior to wound closure. This practice is based on the assumption that the force of the pulse irrigation will more effectively remove adherent bacteria. However, there has been no study of the effectiveness of pulse irrigation in clearing bacteria from the surface of prostheses.

Hypothesis: Pulse irrigation is more effective than bulb irrigation in removing intraoperative bacterial contaminants from prosthetic surfaces.

Method: The matte and polished surfaces of hemiarthroplasties were studied separately. Each surface was contaminated with Staph. epidermidis and then irrigated with pulse or bulb irrigation. The surface was then swabbed using a standardized technique. The swab tips were quantitatively cultured.

Results: Twelve surfaces in each group were tested. Results are expressed as %mL of contaminant bacteria recovered. The matte finish groups showed 4.2x10^-2 and 9.5x10^-4 while the polished finish groups showed 5.0x10^-3 and 8.3x10^-6 with bulb and pulse irrigation, respectively. Significantly fewer bacteria were recovered after pulse irrigation (p=0.0039) for both matte and polished surfaces.

Summary: Under the experimental conditions used, pulse irrigation was more effective than bulb irrigation in removing contaminant bacteria from prosthetic surfaces.