Timing of open debridement for suspected infection of joint prosthesis: a report on 551 patients

Background The aim of this study was to evaluate the results of an ad hoc approach versus using a protocol, with regard to the recording persistent wound drainage after primary joint prosthesis and the effect on the salvage rate. Methods Charts of patients after primary total joint prostheses were studied. Two-hundred and fifty prostheses formed the retrospective group 1 (ad hoc approach) and 308 prostheses formed the prospectively followed group 2 (protocol group). Results Although the percentage of patients with persistent wound drainage in group 2 was almost twofold that of group 1, the number of debridements carried out was lower; the salvage rate in this group was higher. Conclusions Observation and treatment using a protocol yields a significant increase in the number of persistent wound drainages registered. Besides better registration, using a protocol enables more successful selection of patients in whom open debridement is not necessary.