🧼How To Reduce Your Risk of Getting an Infection
Infection after knee replacement is an uncommon but devastating complication. It can lead to further surgery, prolonged courses of antibiotics and worse outcomes. However, there are some simple steps you can take in the months and weeks leading up to your operation that substantially reduce your risk.
How to Reduce Your Risk
Several medical conditions and medications affect how well your immune system fights infection. The months before your operation are the time to get these optimised. If you smoke, stop. If you have diabetes, make sure your blood sugar control (measured by a blood test called HbA1c) is good. If you are overweight, focus on diet and exercise to bring your weight down. All of these will dramatically reduce your infection risk, and you can find separate information modules about each on the main page. Infections elsewhere in your body can act as a focal point, seeding off into the bloodstream and causing infection in the knee. For this reason, make sure any potential sources of infection are under control. For example, if you are prone to urinary tract or chest infections, try to get these treated early (including addressing any underlying cause for it such as problems with your prostate, COPD etc), sort out any dental issues, and look after your skin so it is not broken or damaged prior to surgery. Damaged or infected skin is one of the most common reasons why knee replacement surgery needs to be cancelled on the day, and is largely avoidable if the correct precautions are taken.
The days before surgery
Before your knee replacement, you will be given a bottle of Octenisan, and that contains an antiseptic called chlorhexidine. It is critical that you use this as directed. This helps reduce the bacterial load on the skin and needs to be used for at least 48 hours before surgery. Please see the next section for more information on how to do this. Don't shave for a few days before surgery as there's good evidence this actually increases the risk of infection by creating tiny microabrasions which are then colonised by bacteria. Your surgeon will trim any hair using clippers just before surgery if this is required.
Before your knee replacement, you will be given a bottle of 'Octenisan', an antimicrobial wash lotion. It is critical that you use this as directed. It helps reduce the bacterial load on the skin and needs to be used for 48 hours before surgery. Please see the next section for more information on how to do this. Don't shave in the 3 days before surgery as there's good evidence this actually increases the risk of infection by creating tiny microabrasions which are then colonised by bacteria. Your surgeon will trim any hair using clippers just before surgery if this is required.
If you do have any problems with your skin in the weeks before surgery, please let your surgical team know straight away.
After surgery
Follow the wound care advice given to you, keep the dressing clean and dry, and wash your hands before touching the area.
Contact your team promptly if the wound becomes red, swollen, hot, painful or starts to leak, or if you develop a fever.
Practical tips
- Treat your antibacterial body wash like a prescription — follow the instructions exactly.
- Tell your team about any new coughs, colds, urinary symptoms or skin problems in the week before surgery to avoid a cancellation on the day. It may be safer for you to delay surgery.
- Try to optimise any other medical conditions, especially if you have diabetes or any other condition or medications that suppress your immune system or make it more likely you will develop an infection,.