Journal of Orthopedic and Spine Trauma (Apr 2024)
Comparison of the use of two washing solutions (diluted betadine and normal saline serum) in bilateral knee joint replacement surgery from 2019-2021
Abstract
Background: One of the proposed methods to reduce the risk of infection after joint replacement surgery is the use of disinfectant solutions at the end of the surgery. Different results have been reported regarding the effect of diluted betadine washing solutions and normal saline in reducing the risk of infection around the prosthesis. Purpose: The purpose of this retrospective cohort study is to compare the use of diluted betadine wash solutions and normal saline in bilateral knee replacement surgery. Materials and methods: In this retrospective cohort study, 320 patients who were referred to Baath Hospital from the beginning of 2019 to the end of 2021 for bilateral knee joint replacement were examined. One knee was washed with diluted betadine (35%) and the other with normal saline for 3 minutes before closing the wound. Demographic information, risk factors, and the rate of infection of the prosthesis area in these patients were examined three months after surgery. Results: The average age of the patients was 64.5±6.1 years and their BMI was 27.7±2.0 kg/m2. Out of 320 patients, 177 (55.3%) were women, and the most underlying disease was type 2 diabetes with a frequency of 64 (20.0%). Out of 640 cases of operated knees, 17 cases (2.7%) of prosthetic area infection occurred after surgery, of which 11 cases (4.3%) were washed with normal saline (P=0.326). Multivariate regression analysis test showed male patients (P=0.028, OR=3.38). Patients with diabetes, (P=0.030, OR=3.03) blood pressure, (P=0.019, OR=3.81), and with the increase of each BMI unit (P=0.030, OR=1.36), the chance of infection in patients showed a significant increase. Conclusion: The use of diluted betadine solution in bilateral knee replacement surgery for washing at the end of the surgery, especially in patients with underlying disease and obesity, can reduce the risk of infection.
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