Randomized Controlled Trial of Intrawound application of Vancomycin powder in Total Hip and Knee Arthroplasty as compared with standard postoperative antibiotics in preventing postoperative infections.

Following approval from the Institutional Ethical Committee, All Patients admitted in JSS hospital, Department of Orthopaedics, Mysuru above the age of 18 years who will undergo Total Hip Replacement and       Total Knee Replacement. After acquiring written, informed consent, Patients will be assessed by a Performa consisting of a series of questions that will contain the necessary information such as patient demographic information such as Age, Sex, Body Mass Index, ASA Classification, diabetes, hemoglobin levels, smoking and alcohol consumption, acute liver disease etc.

Patients who fulfill the inclusion criteria will be taken up for study and after written informed consent, the patient will be randomized into two groups depending upon the local application of Vancomycin powder.

1 gram of Vancomycin is mixed with Normal saline and used for surgical site lavage and 1 gram of Vancomycin powder is applied directly in the wound before closure in the vancomycin group.the Vancomycin group is also given standard post operative antibiotics(Cefuroxime 1.5g). The control group will receive standard post operative antibiotics(Cefuroxime1.5g). Both the groups will be followed for 1 year after the procedure for post operative infections.

Post operatively, patients will be monitored for signs of infection in the early postoperative period, 2 weeks, 6 weeks, 3 months, 6 months and 1 year by clinical examination, radiological, microbiological and blood investigations if necessary.

At the end of study period, both the groups will be statistically compared to come to a conclusionbased on the data obtained from the study.