Methods to Prevent Infection:  

- See: Orthopaedic Infection Menu: 

- Pre-Admission Considerations:
     - Diabetic Control:
             - preoperative blood glucose should be less than 125 and postoperative glucose should be less than 200;
             - ref: Risk Factors for Surgical Site Infection Following Orthopaedic Spinal Operations 
     - Nasal MRSA / MSSA Screening:
             - preoperative nasal swabs should be mandatory in all patients, and elective surgical patients should be decolonized prior to admission;
             - decolonization methods:
                         - bactroban cream - patient information, bactroban for MDs, bactroban maker
                         - bacitracin - patients
                         - chlorohexidene
             - references:
                         - Selective Use of Intranasal Mupirocin and Chlorhexidine Bathing and Incidence of MRSA aureus Colonization and Infection Among ICU Patients.
                         - The role of MRSA screening in joint-replacement surgery.
                         - Methicillin-resistant Staphylococcus aureus on orthopaedic wards: incidence, spread, mortality, cost and control.
                         - A Preoperative Decolonization Protocol for Staphylococcus aureus Prevents Orthopaedic Infections.
                         - Staphylococcus aureus Nasal Colonization in Preoperative Orthopaedic Outpatients.

- Hospital and OR Considerations:
     - hand washing:
          - On Washing Hands 


     - antibiotics: 
          - prophylactic antibiotics 
          - local antibiotic delivery 
    - skin Preparation:
          - topical agents:
                - skin prep agents
                - topical antimicrobials  
    - surgeon hygiene
          - double gloving with each glove having a different color (shows perforation): 
          - ioban strips are wrapped around each wrist;
                - Glove perforation in pediatric orthopedic practice. 
                - Glove perforation in ortho and trauma surgery. A comparison between single, double indicator gloving and double gloving with 2 regular gloves. 
                - Glove perforation and contamination in primary total hip arthroplasty. 
    - operating room hygiene:
          - trays are not opened until surgery is ready to begin;
          - minimize use of nitrogen driven equipment;
          - environmental swabbing on a regular basis;
          - references:
                - Intraoperative Contamination Influences Wound Discharge and Periprosthetic Infection. 
                - Unnecessary hospital infection control practices in Thailand: a survey. 
                - The hygienic significance of operating lights 
                - Transfer of bacteria between biomaterials surfaces in the operating room-An experimental study. 
                - Microbial colonization of tourniquets used in orthopedic surgery. 
                - Perioperative contamination in primary total hip arthroplasty.
                - Time-Dependent Contamination of Opened Sterile Operating-Room Trays
          - perioperative oxygen 
          - normothermia: 
                - Perioperative Normothermia to Reduce the Incidence of Surgical-Wound Infection and Shorten Hospitalization  
    - wound management: 
          - suture materials: PDS plus suture
          - closed suction wound dressing;

 





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