Study of the relationship between nasal staphylococcus aureus carrying and surgical site infection on the patients that we will APPLY hip and knee prosthesis

ABSTRACT STUDY OF THE RELATIONSHIP BETWEEN NASAL STAPHYLOCOCCUS AUREUS CARRYING AND SURGICAL SITE INFECTION ON THE PATIENTS THAT WE WILL APPLY HIP AND KNEE PROSTHESIS Pain caused by illnesses like arthroplasty degenerative arthritis is an successful surgical method which increases life quality of the patient, applied on situations like eliminating deformity and movement restrictions, conservative treatment and other situations where all other surgical methods are inadequate. Success on arthroplasty hinges upon many factors. Appropriate indication, selection of patient, sufficient surgical technique, conditions of operating room and postoperative rehabilitation play an important role on success. Although results from arthroplasty operations are mostly successful, possible complications may also cause saddening problems for surgeon and the patient. To minimize these complications, a good preparation before operation, an attentive surgical application and nursing after a careful operation are needed. One complication that is seen often after arthroplasty and has bad results is infection. Preoperative risk factors which increases infection risk therefor should be investigated minutely and minimized. Among the infection determinants, surgical site infection that forms with Staphylococcus aureus has a significant place. It is known that front part of the nose ıs the most common Staphylococcus aureus carrying section. For this reason, nasal wipe sample is taken from each patient on whom we will perform arthroplasty operation preoperatively in terms of staphylococcus aureus carrying. Relationship between carrying nasal Staphylococcus aureus and surgical site infection on the patients that we will apply hip and knee prosthesis is researched. In our study, 65 patients on whom we plan to perform arthroplasty operation and who applied to Fırat Unıversity Department of Orthopedics and Traumatology between 2014 and 2015 are evaluated as prospective. Since four patient diead during postoperative stage, they were not included in the study. Total hip prosthesis operations to sixteen patients (%26.2), total knee prosthesis operations to 27 patients (%44.3), partial hip prosthesis after hip fracture operations to 18 patients are performed. Our patients were 47 female (%77), and 14 males (%23). Average age of the followed patients was 68.4 (28-95). Nasal Staphylococcus aureus carrying is detected on 8 (%13.1) patients, and carrying was not detected on 53 (%86.9) patients. On the follow-up of our patients surgical site infection is seen on 9 (%14.8) patients. No infection was detected on fifty-two (%85.2) patients. Of 9 patients with infection, on 5 of them superficial surgical site infection, on 3 of them deep surgical site infection and on 1 of them prosthesis infection had a progress. Of 8 patients who have nasal Staphylococcus aureus carrying, on 3 of them surgical site infection progressed and reproduction related to carrying on mark culture, and on 5 of them reproduction related to carrying is not detected. In consideration of these results, preop, perop and postop close follow-ups of our patients on whom we will apply prosthesis should be done and evaluated in terms of nasal carrying. Follow-up and treatments of these patients should be standardized according to the diagnosis and treatment algorithm which will be formed by clinics. During the treatment, necessary aids should be taken by being in a constant touch with infection diseases and microbiology clinics. Especially, thanks to the some new techniques that came out recently, determinants of infections are confirmed precisely and their treatment with the antibiotics to which they are sensitive is possible. Key words: Surgical site infection, Nasal staphylococcus aureus carrying, arthroplasty