From two orthopaedic theatres at Pretoria Academic Hospital 28 samples were randomly selected, including Hibiscrub soap dispensers and both fully-sealed and partially-used bottles of iodine/alcohol, Hibitane/alcohol and Hibitane/water. Samples were taken from the solutions and the bottlenecks and basic microbiological cultures were done. Only the Hibitane/water bottles yielded positive cultures, with Bacillus species cultured from three out of four.

We concluded from this small random study that with the exception of Hibitane/water mixtures it should be safe to use the same bottle of solution in different cases.

This was a prospective study to evaluate the changes in bacterial colonisation of the skin during hospital admission for elective surgery. It involved 48 patients who were admitted the day before surgery to Pretoria Academic and Pretoria East Hospitals. Within two hours of admission, cotton-tipped pus swabs were used to obtain samples from 56 skin sites in 48 patients. Postoperative specimens were obtained the day after surgery. The pre-operative cultures revealed a 73% Coagulase Negative Staphylococcus (CNS). Postoperative cultures revealed a 63% CNS. Preoperative methicillin resistance of the CNS was 6% and postoperative resistance to 49% (p < 0.01). The resistance of the organism to Cefazolin increased from 11% to 37%.

This study clearly indicates that multiple drug-resistant organisms colonise the skin of patients in the perioperative hospital stay. The postoperative rise in methicillin resistance of the CNS was alarming. Questions arising from this study include optimal admission time, length of postoperative stay, choice of perioperative antibiotic, use of occlusive dressings to prevent colonisation of wound site and routine screening for Methicillin-resistant CNS skin contaminants.

Purpose: A modification of the arthrodesis as described by F R Thompson is reviewed in ten children.

Method: Between September 1997 and July 2001, six patients ranging from 6 to 13 years underwent hip arthrodesis. Indications included trauma (one), idiopathic chondrolysis (one) post-septic arthritis (four) and tuberculosis of the hip joint (four). The subtrochanteric osteotomy was performed as a coronal chevron, differing from the previously described techniques. Patients were immobilized in a spica (six) and external fixation (four) in a functional position of 20 degrees flexion and neutral position (1degree abduction per year of growth left) for six weeks postoperatively.

Conclusion: This review re-establishes hip arthrodesis as an acceptable treatment for children with destroyed joints and intractable pain. The modification used provides an attractable alternative in preventing the displacement of the subtrochanteric osteotomy, but allows correct positioning of the limb. The use of the external fixation allows lengthening if needed.