The Frank Stinchfield Award: Preoperative Surgical Skin Cleansing Protocols Are Not Effective at Decreasing the Burden of Cutibacterium acnes Before Total Hip Arthroplasty.

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

Three hundred thirty-seven patients with primary hip or knee osteoarthritis undergoing elective lower extremity arthroplasty with hip skin biopsies were randomized to receive either standard preoperative skin preparation with 4% chlorhexidine gluconate alone (n = 173) or the same standard preparation plus four preoperative applications of 5% benzoyl peroxide gel over 48 hours and one additional application on the morning of surgery (BPO; n = 164). The primary outcome of interest was the proportion of patients with a positive dermal culture for Cutibacterium acnes from six 3-mm punch biopsies obtained after intraoperative skin preparation and before antibiotics. Secondary outcomes included the overall rate of any positive culture, the spectrum of cultured organisms, and differences in colonization between anterior versus lateral biopsy locations and between proximal, middle, and distal sites along hypothetical THA incisions. Outcomes were assessed intraoperatively at a single time point, with cultures held for 14 days. Overall, the results of the study revealed that 11% of biopsies yielded positive cultures and that C. acnes colonization rates were high and similar between groups, with no differences by surgical approach or sampling level. These findings suggest that current preoperative cleansing protocols, including the addition of BPO as used in this study, are not effective at meaningfully reducing the dermal burden of C. acnes before THA.