Infection in prosthetic material

Surgical site infections are a common complication affecting 5% of patients. They impact not only on morbidity and mortality but have significant economic implications. The aetiology involves the interplay of host, environmental and pathogen factors all of which need to be addressed 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 Staphylococcus epidermidis. Antibiotic treatment alone is often ineffective due to biofilm formation and as such prosthesis removal may be necessary. Work to develop biological prostheses is ongoing and may reduce the incidence of prosthetic infection in the future however it will still be imperative to optimize the patient preoperatively.