The Luck of the Bionic

You may not want to leave it all up to luck when choosing to go through with a prosthetic implantation. Much precaution and careful consideration of a variety of factors must be taken into account. Last week, I discussed several guidelines to prevent infection before/during/after surgical procedures. Today, I want to talk about specific prevention procedures for several implants. In order to make the explanation very clear, I will be using an outline format with the following subsections: Infection, Symptoms, and Prevention Procedure. 

1. Intraocular Lens Implants
• Infection: staphylococci and Staphylococcis aureus 
• Symptoms: ocular pain, decreased vision, headache, and photophobia (abnormal intolerance to visual perception of light)
• Prevention Procedure: 5% poviodone-iodine solution and 10% iodine wash of the lids (commonly recommended as a preoperative disinfectant) 
2. Prosthetic Joints
• Infection: The incident of infection of total joint prostheses over a 10 year span at one institute was 1.7%. Most common pathogens are the staphylococcus species. 
• Symptoms: pain, spontaneous wound drainage, failure of wound to heal in the early postoperative period
• Curing may require a combination of device removal and antibiotics. 
• Prevention Procedure: 1 gram of cefazolin before surgery and then no more than two or three doses postoperatively. 
3. Dental Implants 
• Common Infection: Streptococcus sanguis, Actinomyces viscosus, Actinomyces odontolyticus 
• Symptoms: inflammation, plaque build up, bleeding
• Prevention Procedure: perioperative chlorhexide (0.12%), twice daily mouth rinse with antiseptic reduces plaque formation on dental implants
4. Cochlear and Ossicular Implants
• Infection: meningitis 
• Symptoms: fever, headache, confusion, sensitivity to light
• Prevention Procedure: prophylactic antibiotic in cochlear implant operations 

Hope this section is helpful. If anyone would like more information on the above or other commonly used prosthetic devices, please comment below. Otherwise, stay tuned for next week as I dive into some case studies and further uncover The Intriguing Connection. 

Sources: 

1. Meningitis. (n.d.). Retrieved March 17, 2015, from http://www.mayoclinic.org/diseases-conditions/meningitis/basics/symptoms/con-20019713
2. Prevention of Infection in Prosthetic Devices. (2006). In F. Johnson & K. Virgo (Eds.), The Bionic Human. Totowa, NJ: Humana Press.