Evidence map›Paper›PMID 39550574›Full record

ArticleTrials2024

Efficacy of the preformulated irrigation solution Bactisure® in acute periprosthetic joint infection debridement surgery: study protocol for a randomized controlled trial.

Rafael Oleo-Taltavull, Matías Vicente Gomà-Camps, Nayana Joshi Jubert, Pablo S Corona

Erratum issuedAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Rafael Oleo-TaltavullOrthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain. rafael.oleo@vallhebron.cat.ORCID http://orcid.org/0000-0002-0978-9015
Matías Vicente Gomà-CampsOrthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain.
Nayana Joshi JubertOrthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain.
Pablo S CoronaOrthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite significant progress in orthopaedic surgery, the prevalence of periprosthetic joint infections (PJIs) remains persistent, and future increases are expected due to the increasing number of joint arthroplasties. PJIs are intricately connected to biofilm-producing bacteria, which encase infected prostheses, impairing the effectiveness of antibiotics and the immune system. Acute PJIs with immature biofilms are traditionally managed with debridement, antibiotics, and implant retention (DAIR). However, to date, there has not been a conclusive direct clinical comparison (in vivo) demonstrating the superiority of one irrigation solution over others. Recently, there has been a growing interest in irrigation solutions with antibiofilm properties demonstrated in in vitro studies, exemplified by the preformulated Bactisure® irrigation solution, which contains ethanol, acetic acid, sodium acetate, benzalkonium chloride, and sterile water. The main objective of this study was to evaluate the effectiveness (infection cure rate) of preformulated Bactisure® irrigation solution in vivo compared with saline solution in a control group of patients with acute knee and/or hip periprosthetic infections treated with DAIR.

methodsProspective single-centre randomized controlled trial involving patients with acute haematogenous PJI who received standard DAIR surgery from December 2022 to December 2024. The type of irrigation solution used during surgery will include two groups allocated at a 1:1 ratio: a control group (n = 25) with saline solution and an experimental group (n = 25) receiving the Bactisure® preformulated solution. The sample size was calculated based on an expected reduction in reinfection rates from 45% in the control group to 10% in the experimental group. Data on baseline patient characteristics, clinical and radiological information, and healthcare questionnaires will be recorded. All patients will be followed for minimum of 12 months. The infection cure rate at 1 year will be the primary outcome. DISCUSSION: This study is the first to compare the effectiveness of preformulated Bactisure® irrigation solution with that of saline solution in real clinical practice (in vivo) in patients with acute knee and/or hip periprosthetic infections treated with DAIR. Our main hypothesis is that, compared with saline solution, Bactisure® provides a better infection cure rate at 1 year post-DAIR.

trial registrationInternational Standard Randomized Controlled Trial Number (ISRCTN): https://doi.org/10.1186/ISRCTN10873696 . Registered on December 19, 2023.

Indexed as

Acetic AcidArthroplasty, Replacement, KneeDebridementProsthesis-Related InfectionsTherapeutic IrrigationAnti-Bacterial AgentsArthroplasty, Replacement, HipBiofilmsEthanolHip ProsthesisHumansKnee ProsthesisProspective StudiesRandomized Controlled Trials as TopicSaline SolutionTreatment OutcomeAcetic AcidAnti-Bacterial AgentsEthanolSaline SolutionDebridement antibiotic and implant retention (DAIR)HipIrrigation solutionKneePeriprosthetic joint infection

Identifiers

PMID39550574
PMCPMC11568522

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.