Use of Chlorhexidine Preparations in Total Joint Arthroplasty

Journal of Bone and Joint Infection
Jaiben GeorgeCarlos A Higuera

Abstract

Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue. Although chlorhexidine is relatively cheap, routine use of chlorhexidine without evidence of clear benefits can lead to unnecessary costs, adverse effects and even emergence of resistance. This review focuses on the current applications of various chlorhexidine formulations in TJA. As the treatment of PJI is challenging and expensive, effective preparations of chlorhexidine could help in the prevention and control of PJI.

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Citations

Oct 9, 2019·Plastic and Reconstructive Surgery. Global Open·Mathew T EppsMark A Brzezienski
Aug 30, 2018·Journal of Bone and Joint Infection·James X LiuMandeep S Virk
May 23, 2017·Journal of Bone and Joint Infection·Antonia F Chen, Heinz Winkler
May 1, 2018·AORN Journal·Charles E EdmistonHelen Boehm Johnson
Aug 23, 2019·Nursing·Maureen KroningMary Leahy
Feb 23, 2019·Clinical Orthopaedics and Related Research·Jaiben GeorgeCarlos A Higuera
Jun 11, 2021·Journal of Bone and Joint Infection·Ahmed SiddiqiAntonia F Chen
Aug 2, 2021·International Journal of Pharmaceutics·Matteo MaraldiDavide Moscatelli
Aug 14, 2021·Surgical Infections·Dominique M DockeryDioscaris R Garcia
Sep 15, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Johannes F PlateThorsten M Seyler

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Methods Mentioned

BETA
total hip arthroplasty

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