Clinical Analysis Of Bacterial Culture At The Tip Of Negative Drainage Tube In Different Extubation Time After Arthroplasty

Background With the improvement of people's living standards and the implementation of various medical insurance policies in our country,more and more people have accepted the arthroplasty.The success of arthroplasty not only requires surgeons with skilled surgical skills,but also guides patients in effective postoperative functional exercise,and need to pay attention to prevention and treatment of surgery-related complications.The problem of prosthetic joint infection(PJI)after arthroplasty has always been a concern for surgeons and a problem that patients are afraid to face.Because once the occurrence of prosthetic joint infection means surgery failure,followed by only a second revision surgery,the difficulty and risk of surgery is much greater than the initial replacement,severe infection is difficult to control even need amputation.Therefore,all clinical practice that can increase the risk of postoperative infection should draw the attention of medical personnel.It is common practice to place a negative pressure drainage tube after arthroplasty to reduce the risk of postoperative hematoma and infection.However,if the negative pressure drainage tube is placed too long,the bacterial retrograde infection can occur,it is of great clinical significance to explore the timing of the removal of the negative pressure drainage tube after arthroplasty.Objective Clinical analysis of bacterial culture at the tip of negative drainage tube in different extubation time after arthroplasty.Methods 168 negative pressure drainage tubes of 84 patients with unilateral arthroplasty were prospectively cultured.Among them,40 cases were unilateral knee arthroplasty,44 cases were unilateral hip arthroplasty.At the end of each patient's operation,a negative pressure drainage tube was temporarily placed below the fascia layer,and removed immediately,3cm of drainage tube tip for bacterial culture,this is the control group.Then divided other cases into two test groups according to the time after extubation: in group A,42 drainage tubes were removed in 24 hours after surgery,and in group B,the other 42 drainage tubes were removed 48 hours after surgery,and obtain 3cm tip of drainage tube for bacterial culture.All the patients were followed up for 3 months after surgery to see if there was any joint infection.The results of bacterial culture and follow-up were analyzed.Results The control group had no bacterial growth at the tip of the drainage tube,but in the test group,some cases appeared bacteria.According to the analysis of extubation time,there were 6 cases(7.14%)with positive bacterial culture in the drainage tube of group A,among them,there were 5 cases(5.95%)of Ralstonia pickettii and 1 case(1.19%)of Escherichia coli.In group B,2 cases(2.38%)of the drainage tubes were positive,of which 1 cases(1.19%)of Ralstonia pickettii,1 cases(1.19%)of Citrobacter freundii,the difference between two groups of positive rate was not statistically significant(P > 0.05).According to the types of arthroplasty,5(5.95%)of the drainage tubes were positive after unilateral hip arthroplasty,and 3(3.57%)of the drainage tubes were positive after unilateral knee arthroplasty,the difference between two methods of positive rate was not statistically significant(P > 0.05).All patients were followed up for3 months without symptoms of joint infection,including those with positive cultures.Conclusion Bacterial culture at the tip of the drainage tube after arthroplasty of little value in the diagnosis of joint infection.In the case of prophylactic antibiotics,extubation was safe within 48 hours after arthroplasty.