Abstract
Objectives Despite advances in surgical asepsis and improvements in sterile surgical techniques,
surgical site infection occurs in 0.8 to 15.8% of surgical wounds. Most infections
are caused by microorganisms forming biofilms that adhere to implants or dead bone
and can evade host immunity and antimicrobial agents. Simini Protect Lavage (SPL)
is a hypertonic aqueous solution designed to break cross-links within the extracellular
polymeric substance of biofilms produced by bacteria. This study aimed to report the
outcome of our total hip replacement (THR) revision cases using an SPL in addition
to our standard antiseptic protocol.
Methods The medical records of patients at Vezzoni Veterinary Clinic were searched for animals
undergoing a revision orthopaedic surgery involving a THR that included the use of
SPL. In all patients, a minimum of 1-year follow-up and culture and a sensitivity
test pre- and post-Simini Lavage were required.
Results SPL was used in 36 cases. At the beginning of surgery, culture and sensitive tests
were positive in eight patients, and at the end of surgery, seven dogs were still
positive for bacterial infection. Only one case, which experienced three revision
surgeries, underwent explantation due to persistent, clinically evident infection.
The other dogs showed neither clinical nor X-ray signs of infection over a long period.
Clinical Significance The use of SPL can be considered as an adjuvant in the antiseptic protocol for the
one-stage revision THR surgeries without a plan of prosthesis explanation. Nevertheless,
further studies are needed to objectively evaluate the efficacy of SPL in eradicating
the postoperative infections.
Keywords
infections - surgical site infection - revision surgery - intraoperative antiseptic
lavage
