Comparison of Surgical Glove Contamination During Total Knee Arthroplasty Procedure : a Randomized Controlled Trial

Study Overview
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Brief Summary
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Total knee arthroplasty post-op surgical site infection rate about 0.5- 5% Pre-operative , perioperative and post-operative prevention are importance for reduce surgical site infection The prevention of surgical-site infections (SSIs) is an integral component of nosocomial infection control and a major priority in orthopedic surgery. Surgical wound contamination must be prevented to avoid patient colonisation by microorganisms during surgery. Surgical glove changing perioperative can reduce contamination and perforation rate Orthopedic surgery had found contamination rate about 20-28 % Joint replacement procedure found contamination rate about 38-67% of all orthopedic surgery 12% of gloves are contaminated after draping and 24% once patient installation is complete. We hypothesis that changing surgical glove during total knee arthroplasty can reduce contamination rate on surgical glove.

Detailed Description
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Total knee arthroplasty post-op surgical site infection rate about 0.5- 5% Pre-operative , perioperative and post-operative prevention are importance for reduce surgical site infection The prevention of surgical-site infections (SSIs) is an integral component of nosocomial infection control and a major priority in orthopedic surgery. Surgical wound contamination must be prevented to avoid patient colonisation by microorganisms during surgery. Surgical glove changing perioperative can reduce contamination and perforation rate Orthopedic surgery had found contamination rate about 20-28 % Joint replacement procedure found contamination rate about 38-67% of all orthopedic surgery 12% of gloves are contaminated after draping and 24% once patient installation is complete. Research question : Does changing surgical glove during total knee arthroplasty can reduce contamination rate on surgical glove? Population : Patient who schedule for primary total knee arthroplasty in Srinagarind hospital Inclusion criteria :Patient who schedule for primary total knee arthroplasty in Srinagarind hospital Exclusion criteria : Patient factor Patient who had previous open knee surgery Patient who have remote infection at period of surgery for total knee arthroplasty Patient who have lower extremity infection same side at total knee arthroplasty prior 48 hrs Surgical glove factor gross perforation Glove changing not include in criteria for study group Primary outcome : -Comparison contamination rate of surgical glove in treatment group and control group Secondary outcome : -Contamination rate in draping method period and surgical procedure prior to cementation period in total knee arthroplasty Study design: a randomized controlled trial Treatment group glove changing after draping and before cementation glove changing before cementation Control group -no glove change Pre-operative protocal iv. Cefazolin 1 hour prior to incision skin preparation by Betadine scrub Draping including entire limb from thigh to foot pre-operative hand wash by Betadine scrub for at least 2 minutes Perioperative protocal Operating room include horizontal laminar flow Use Ansell GAMMEX latex powdered surgical glove for all glove include in this study Post-operative protocal antibiotic prophylaxis for 24 hours post-op The five fingertips of each hand were placed on blood agar immediately before each set of gloves were removed Culture plates were subsequently incubated at 37°C for 48 hours. A single microbiologist reported the results of the culture. The number of colonies counted as the number of colony-forming units (CFU) per dish and types of organisms were recorded identified all bacterial isolates by using Gram stain coagulase oxidase catalase tests. The degree of contamination was divided into three grades no contamination if there was no growth low contamination where between one and five colonies heavily contaminated if there were more than five colonies

Official Title
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Comparison of Surgical Glove Contamination During Total Knee Arthroplasty Procedure

Conditions
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Surgical Glove, Total Knee Arthroplasty, Contamination Rate

Intervention / Treatment
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* Procedure: Surgical glove changing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient who schedule for primary total knee arthroplasty Exclusion Criteria: Patient who had previous history of open knee surgery Patient who have remote infection during period of total knee arthroplasty Patient who have infection around lower extremity at the same site of total knee arthroplasty
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Comparison contamination rate of surgical glove in control group and surgical glove changing group during total knee arthroplasty procedure
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Control group<br>No surgical glove changing during total knee arthroplasty procedure | Procedure: Surgical glove changing<br>* Changing surgical glove after draping and before cementation during total knee arthroplasty<br>|
| Experimental: Treatment 1 group<br>Changing surgical glove after draping and before cementation during total knee arthroplasty procedure | Procedure: Surgical glove changing<br>* Changing surgical glove after draping and before cementation during total knee arthroplasty<br>|
| Experimental: Treatment 2 group<br>Changing surgical glove before cementation during total knee arthroplasty procedure | Procedure: Surgical glove changing<br>* Changing surgical glove after draping and before cementation during total knee arthroplasty<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| comparison contamination rate on surgical glove | Contamination rate on surgical glove during total knee arthroplasty | 30 months from randomization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contamination rate on surgical glove | Contamination rate on surgical glove during period after draping and before cementation | 30 months from randomization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total knee arthroplasty, Surgical glove, Contamination rate