Forecast Possibilities and Prophylaxis of Surgical Site Infections in TKA

A retrospective review of 814 Total Knee Replacements, performed in NWSMU named after I.I. Mechnikov had been conducted for the study. It had shown 20 significant criteria which can influence the occurrence of surgical site infections in postoperative period. Among these factors 15 can be identified pre-surgery, 4 -intraoperatively and 1- postoperatively. The criteria are: age, gender, host optimizations, preoperative management quality, duration of surgery and operating room (OR) conditions, intraoperative complications, amount of blood lost etc. All these factors were estimated and included in a scaling system. A specific software was created based on this system that can forecast the complications in the area of surgical intrusion in early post-operative period. Afterwards a forecast and prevention algorithm for preventing septic complications in Total Knee Replacement had been developed and applied. In prospective study (174 clinical observations) the application of the forecast and prevention algorithm had resulted in significant decrease rate of septic site complications compared to the cases of retrospective research (decrease of 5.3% in the prospective cases and 2.3% - in retrospective).