Infection in prosthetic material

Surgical site infection (SSI) occurs when a wound created as part of a surgical procedure becomes infected. SSI is one of the most common healthcare-associated infections and occurs in approximately 5% of patients undergoing a surgical procedure. SSI may lead to patients suffering considerable morbidity or mortality and have significant cost implications. The aetiology involves the interplay of host, environmental and pathogen factors all of which should be addressed in seeking to reduce the risk of developing an infection. The presence of prosthetic material reduces the number of bacteria necessary for an infection to develop and can give rise to treatment and diagnostic difficulties. The responsible organisms are most commonly Staphylococcus aureus and S. epidermidis. Diagnosis is frequently problematic and antibiotic treatment alone is often ineffective due to biofilm formation necessitating removal of prosthesis in many cases. Prevention of infection is by far the most important aspect of prosthetic implant surgery. Patient optimization is equally important as the cutting edge research into biological prostheses in reducing the incidence of prosthetic infection in future practice.