Deterioration of theatre discipline during total joint replacement--have theatre protocols been abandoned?

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Abstract

[Indexed for MEDLINE] 12. Asian Spine J. 2013 Jun;7(2):91-5. doi: 10.4184/asj.2013.7.2.91. Epub 2013 May 22. Reduction of halo pin site morbidity with a new pin care regimen. Kazi HA(1), de Matas M, Pillay R. Author information: (1)Spinal Unit, Department of Orthopaedics, Royal Liverpool University Hospital, Liverpool, UK. STUDY DESIGN: A retrospective analysis of halo device associated morbidity over a 4-year period. PURPOSE: To assess the impact of a new pin care regimen on halo pin site related morbidity. OVERVIEW OF LITERATURE: Halo orthosis treatment still has a role in cervical spine pathology, despite increasing possibilities of open surgical treatment. Published figures for pin site infection range from 12% to 22% with pin loosening from 7% to 50%. METHODS: We assessed the outcome of a new pin care regimen on morbidity associated with halo spinal orthoses, using a retrospective cohort study from 2001 to 2004. In the last two years, our pin care regimen was changed. This involved pin site care using chlorhexidene & regular torque checking as part of a standard protocol. Previously, povidone iodine was used as skin preparation in theatre, followed by regular sterile saline cleansing when pin sites became encrusted with blood. RESULTS: There were 37 patients in the series, the median age was 49 (range, 22-83) and 20 patients were male. The overall infection rate prior to the new pin care protocol was 30% (n=6) and after the introduction, it dropped to 5.9% (n=1). This difference was statistically significant (p