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From the patient’s own flora when transferred to the gloves, working surfaces and then to the implants. The quality of air is not pristine; studies have shown bacterial growth inside the sterile field with increase in exposure time.
Most patients are immunocompromised, and therefore more susceptible to infections.
Exposure to local vancomycin and betadine irrigation of implant-bone interface is impossible post implantation.
Bioavailability of systemic vancomycin at implant-bone interface is low to none, due to delay in host site integration.
Latest evidences have shown occurrence of occult infection, which manifests as hardware loosening or dislodgement, thus requiring a revision surgery.
