A retrospective study of antibacterial iodine-coated implants for postoperative infection

Medicine (Baltimore). 2019 Nov;98(45):e17932. doi: 10.1097/MD.0000000000017932.

Abstract

Postoperative infection is one of the most serious complications in orthopedic surgery. We have developed and use iodine-coated implants to prevent and treat postoperative infection in compromised hosts. This study evaluated outcomes using iodine-coated implants for postoperative infections.We treated 72 postoperative infected patients using iodine-coated implants. Of these, 38 were males and 34 were females, with a mean age of 59.3 years. The mean follow-up period was 5.6 years. The patients included 23 with an infection following total knee arthroplasty, 20 following total hip arthroplasty, 11 following osteosynthesis, 11 following spine surgery, 6 following tumor excision, and 1 following osteotomy. Of these, 37 underwent single-stage surgery and 35 underwent staged revision surgery. We performed staged surgery in any case with active infection. The survival of iodine-coated implants was determined using Kaplan-Meier analysis. White blood cell (WBC) and C-reactive protein (CRP) levels were measured pre- and postoperatively. To evaluate the systemic effects of iodine, serum thyroid hormone levels were examined.Five patients underwent re-revision surgery. In 3 patients, periprosthetic infection recurred at an average of 18 months after surgery. The reinfection rate was 4.2%. These patients recovered following reimplantation of iodine-coated prostheses. No patients required amputation. The survival rate of iodine-coated implants was 91%. There were no signs of infection at the latest follow-up. The median WBC level was nearly in the normal range, and CRP levels returned to normal within 4 weeks after surgery. No abnormalities of thyroid gland function were detected.Iodine-coated titanium implants can be very effective in the treatment of postoperative infections. An iodine coating can be safely applied to infected regions.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / administration & dosage*
  • Coated Materials, Biocompatible / therapeutic use*
  • Female
  • Humans
  • Iodine / administration & dosage*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Reoperation / adverse effects
  • Retrospective Studies
  • Surgical Wound Infection / drug therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Coated Materials, Biocompatible
  • Iodine