Before reaching for new antibiotic carriers, check the basics that have the strongest evidence. Give the prophylactic antibiotic within the hour before incision, re-dosing for long operations or heavy blood loss. Identify and optimise modifiable risks before elective arthroplasty: uncontrolled diabetes, smoking, obesity, poor dental health and skin lesions near the incision. Screen for and decolonise Staphylococcus aureus carriage where local protocols support it, and keep theatre traffic to a minimum.
- Time antibiotic prophylaxis within 60 minutes before incision, and re-dose for long cases.
- Optimise glycaemic control and stop smoking before elective arthroplasty.
- Check skin near the incision and dental health before listing.
- Limit theatre door openings and staff traffic during implant surgery.
Why it matters
The cheapest infection-prevention steps are also the ones most often missed.
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