No Differences in Bacterial Colonization, Infection With Early Shower s/p TKA

HealthDay News – Results published in the Journal of Arthroplast suggest that it may not be necessary for patients to wait to shower for 2 weeks post-total knee arthroplasty (TKA) to prevent post-surgical site infection. Prior to this study, little research was available empirically investigating optimal timing for postoperative wound care related to showering.  An increasing percentage of patients have indicated preference to shower earlier after surgery. 

The study, led by Harold Rees, MD, an orthopedic surgeon at the Loyola University Medical Center in Maywood, Ill., followed 32 TKA patients. Half were randomly assigned to shower after two weeks. The other half could shower as soon as their surgical dressing was removed — typically two days after surgery.

The researchers found no differences in bacterial swabs from those who waited two weeks to shower compared with those allowed to shower after about two days. None of the patients developed a postoperative infection. And, unsurprisingly, patients permitted to shower sooner were much happier than those who couldn’t. Given a choice, patients said they would have preferred to shower sooner rather than later after their procedure.

“What is needed now is a larger-scale study that can evaluate if early versus delayed wound cleaning has any effect on surgical-site wound infection risk for TKA,” the authors write.

Summary and Clinical Applicability

In this study, no differences were found between early and delayed showering patient groups in surgical site bacterial recolonization rates post primary THA.

This study was funded by DePuy Synthes Joint Reconstruction.

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Yu AL, Alfieri DC, Bartucci KN, Holzmeister AM, Rees HW. Wound hygiene practices after total knee arthroplasty: Does It Matter? J Arthroplasty. 2016; Epub ahead of print March 29, DOI 10.1016/j.arth.2016.03.040