Instead of giving
patients potent antico-
agulants to prevent
post-op blood clots
from forming, a grow-
ing number of joint
replacement surgeons
use aspirin as the sole
anticoagulant, says Dr.
Sporer.
4. Wound clo-
sure
Effective wound clo-
sure is also key to
keeping infections at
bay, because a wound
that weeps after sur-
gery is more prone to
infection. Before clos-
ing the wound, make
sure to copiously irrigate it with fluids.
"Whether you add antibiotics to the irrigation solution is an area of
debate, but most literature suggests that it is not more effective than
antibiotic-free fluid," says Dr. Deirmengian. "An active area of research
includes irrigating the wound with a diluted betadine solution, and
adding antibiotic powder to the joint and wound prior to closure."
Dr. Sporer has stopped using staples to close wounds, opting instead
to place sub-cuticular stitches to improve vascularity and blood supply
at the edges of the wound, factors that have been linked to a reduction
J U L Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 7 9
• WELL-OILED MACHINE Expert surgical teams perform efficient surgery with
shorter operative times, meaning the wound is open for less time and the risk of
infection is lower.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
