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Cyanoacrylate Microbial Sealant May Reduce the Prevalence of Positive Cultures in Revision Shoulder Arthroplasty

  • Symposium: 2012 Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Cyanoacrylate-based, microbial sealant is an adhesive skin barrier designed to prevent bacterial contamination in surgical wounds. This type of adhesive barrier could have use in decreasing the incidence of positive cultures and subsequent infection in shoulder arthroplasty.

Questions/purposes

We therefore evaluated whether cyanoacrylate microbial sealant reduced the positive intraoperative culture rates in revision shoulder arthroplasty.

Methods

We retrospectively reviewed 55 patients who underwent revision shoulder arthroplasties. Intraoperative aerobic and anaerobic deep tissue culture results taken during the revisions were compared. Cultures were taken of the deep synovial tissue lining the prosthesis. Patients were divided into two groups: those who underwent standard preparations with adhesive, iodine-barrier drapes (Group SP) and those who had placement of cyanoacrylate microbial sealant in addition to the standard prep (Group MS).

Results

The prevalence of cases with positive cultures was 18% (seven of 40) in Group SP compared with 7% (one of 15) in Group MS. The prevalence of positive, anaerobic Propionibacterium acnes cultures was 13% in Group SP compared with 7% in Group MS. The prevalence of infections confirmed at revision surgery was 8% in Group SP versus 0% in Group MS.

Conclusions

Our observations suggest application of a cyanoacrylate microbial sealant may reduce the prevalence of positive cultures and thereby subsequent infections in revision shoulder arthroplasties.

Level of Evidence

Level III, retrospective cohort study. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 213, Loma Linda, CA, 92354, USA

    Adam J. Lorenzetti MD, Montri D. Wongworawat MD, Christopher M. Jobe MD & Wesley P. Phipatanakul MD

Authors
  1. Adam J. Lorenzetti MD
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  2. Montri D. Wongworawat MD
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  3. Christopher M. Jobe MD
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  4. Wesley P. Phipatanakul MD
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Corresponding author

Correspondence to Wesley P. Phipatanakul MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained when required.

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Lorenzetti, A.J., Wongworawat, M.D., Jobe, C.M. et al. Cyanoacrylate Microbial Sealant May Reduce the Prevalence of Positive Cultures in Revision Shoulder Arthroplasty. Clin Orthop Relat Res 471, 3225–3229 (2013). https://doi.org/10.1007/s11999-013-2854-5

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  • DOI: https://doi.org/10.1007/s11999-013-2854-5

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