Will Eardley and Helen Smith, from James Cook University Hospital, highlight the impact of implant related infections in orthopaedic surgery and the challenges around biofilm formation. In this article, they consider the role of hydrogel in preventing infections and share their valuable insights into selecting patients who could benefit.
Infection is a negative outcome for any implant related surgical procedure. Repercussions for the patient and the system in which they are cared for are considerable. Limb loss may be an ultimate consequence, while marked limitation of function and quality of life are commonplace in those unfortunate enough to become infected after orthopaedic surgery. Characterised by its multifactorial nature, contributors to prevention of infection in this field are vast. They should be judged on their efficacy, as well as their impact on the patient and the healthcare system. Clinicians should aim to identify and exploit any opportunity to reduce the risk of fracture related or periprosthetic infection for their patients.
Some opportunities incur great expense and resource use and varying risk to patients are encountered in prevention. Other methods are easier, less costly, and more patient acceptable. This article discusses the use of hydrophilic polymer coatings as one example of more acceptable management of patients in whom infection carries especial impact.
No implant is immune to the impact of contamination, bacterial adherence, and subsequent implant related infection. Likewise, there is no patient that can mitigate significant bacterial contamination through host immunity alone without risking the spectre of deep infection either early or late in the post-surgical period.
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