Propionibacterium acnes in shoulder surgery: is loss of hair protective for infection?

Journal of Shoulder and Elbow Surgery
Robert HudekFrank Gohlke

Abstract

Propionibacterium acnes (P acnes) has been linked to chronic infections in shoulder surgery. It was recently observed during first-time shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors. Because the skin biology greatly differs, we aimed to correlate skin complaints with P acnes-positive intraoperative cultures from different tissue layer samples in patients undergoing shoulder surgery for the first time. Intraoperative samples (1 skin, 1 superficial, 1 deep tissue, and 1 control sample) from 112 patients (70 men, 42 women; aged 59.2 years) were cultured. The association between the presence of P acnes in the deep or superficial tissue, or both, and 10 items of a validated preoperative questionnaire for skin pathology was explored. The cultures were positive for P acnes in 38.4% (n = 43) of the cases. Skin samples were positive for P acnes in 8% (n = 9), superficial samples were positive in 23% (n = 26), and deep samples were positive in 30% (n = 34). Self-reported "loss of hair" was significantly negatively associated with the presence of P acnes in the superficial or deep tissue sample (P = .00028). Patients who report having "loss of hair...Continue Reading

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Citations

Jun 28, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Leo PauzenbergerPhilipp Heuberer
Dec 17, 2016·Journal of Orthopaedic Trauma·Elizabeth B GausdenDavid S Wellman
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Jan 18, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Carola F EckChristopher R Adams
Sep 22, 2018·ANZ Journal of Surgery·Mitchell L SmithMatthew C Evans
Feb 26, 2019·Bone & Joint Research·P HernandezM Khazzam
Nov 9, 2018·BioMed Research International·Davide BlonnaRoberto Rossi
May 27, 2020·Journal of Shoulder and Elbow Surgery·Tae Yoon KwonSung-Min Rhee
Jun 18, 2021·Frontiers in Microbiology·Holger BrüggemannRolf Lood
Sep 30, 2021·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Naireen FatimaLene Bay

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