Abstract
Aim
There is controversy about the need of remove implants removal in pediatric patients. One of the potential disadvantages of not doing it is potential infection. Since the orthopaedic implants (O.I.) are handled under an aseptic protocol, the expected results are the absence of germs in those devices. However, the risk of contamination and potential infection cannot be ruled out.
For these reason we wanted to determinate the percentage of colonization in the O.I. removed from pediatric patients of the H.G.G.B. in Concepción, Chile.
Method
Prospective observational study. The population consisted of 137 patients with previous osteosynthesis. 10 patients were excluded who had extruded material. The sample consisted of 127 patients in whom 331 implants were removed. The analysis unit was the cultures of the O.I. removed with aseptic techniques. The data was analyzed by descriptive statistics
Results
19% (63) of the removed material was colonized;
The percentage of positive cultures according to type of material in decreasing order was: Cannulated screws (22.9%), Kirschner wires (20.3%), TENS (7.4%) and plate (6.7%). The first and third are titanium materials, while the second and fourth are made of steel.
The relationship according to type of limb was: 20.5% of the O.I. of the lower extremity and 15.2% of the upper limb.
The relationship according to type of patient was: 24% in elective patients and 13.8% in emergency patients.
The main germs grown in decreasing order were: Staphylococcus epidermidis (69.1%), S. Haemolitycus (9.1%), S. Hominis (7.3%), S. Capiti (5.5%).
Conclusions
The colonization of O.I. removed from pediatric patients is higher than the infections reported in adults. It is striking that colonized material from elective patients is superior to emergency patients. It also highlights that titanium has almost the same colonization level than steel. These results provide evidence to consider the removal of O.I. from pediatric patients, particularly in patients with lower extremity devices.
