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Evidence-Based Protocols for the Prevention and Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty: A Systematic Review
Online Journal of Surgery
| Vol 1, Issue 1
Table 1. Infection Prevention Protocols for Total HipArthroplasty (THA)
| Protocol | Components | Reported Outcomes |
| Antibiotic Prophylaxis [1,15,17,18] | Cefazolin + gentamicin; timing critical (≥45 min pre-incision) | SSI reduced from 1.19% to 0.55% |
| S. aureus Decolonization [15] | Nasal swab + decolonization (mupirocin, chlorhexidine) | Infection rate reduced from 22% to 3% |
| Silver-impregnated Dressings [15] | Antimicrobial dressings reduce acute PJI incidence | Reduces acute postoperative infection |
| ACERTO Protocol [31] | Shorter fasting, immune nutrition, limited IV fluids | Reduced LOS and CRP, improved recovery metrics |
| Multimodal Surveillance (Passive) [20] | 95% of deep infections detected within 90 days | Efficient detection of post-discharge infections |
| (LAF) [20] | Airborne contamination control; conflicting evidence for SSI reduction | No consistent benefit; may increase deep infections |
Legend: THA = Total Hip Arthroplasty; PJI = Prosthetic Joint Infection; SSI = Surgical Site Infection; CRP = C-reactive Protein; LOS = Length of Stay; LAF = Laminar Airflow.