Skin Microbiome and Surgical Site Considerations in Orthopedic and Arthroplasty Surgery

Surgical site infection (SSI) remains one of the most consequential complications in orthopedic surgery, and particularly in joint arthroplasty, where even low infection rates carry a disproportionate burden in revision surgery, patient morbidity, prolonged hospitalization, and healthcare cost. While surgical technique, antisepsis protocol, and patient-specific risk factors are well studied, a growing body of evidence points to the resident skin microbiota, its composition, density, and variation by anatomical incision site, as an underexplored, modifiable factor in infection risk.Differences in microbial flora between commonly used incision sites (for example, in direct anterior versus posterolateral approaches to hip arthroplasty) may partly explain variation in SSI rates that surgical technique alone does not account for. Advances in culture-independent sequencing and microbiome profiling now make it possible to characterize these differences with a level of resolution that was not previously available, opening the door to more targeted prevention strategies.This Research Topic welcomes original research, clinical studies, systematic reviews, and mini reviews exploring the role of skin microbial flora in orthopedic and arthroplasty surgery.We welcome submissions covering, but not limited to, the following themes:•Comparative microbiological studies across incision sites and surgical approaches (e.g., direct anterior vs. posterolateral hip arthroplasty, medial vs. lateral knee approaches)•Impact of preoperative skin preparation, antisepsis protocols, and decolonization strategies on microbial load and infection risk•Associations between skin flora composition (bacterial diversity, density, or specific pathogen presence) and postoperative surgical site infection or periprosthetic joint infection rates•Novel diagnostic tools or biomarkers for infection risk stratification informed by microbiome research•Preventive strategies and perioperative protocols informed by microbiome findings•Clinical outcomes data linking microbial findings to revision rates, length of stay, readmission, or cost of care•The influence of patient-specific factors (e.g., skin condition, comorbidities, prior antibiotic exposure) on skin microbiota and infection riskThe aim of this Research Topic is to consolidate current evidence on skin microbiota in orthopedic and arthroplasty surgery and highlight actionable strategies for reducing surgical site infection through better understanding of skin flora, incision-site variation, and antisepsis practice.Topic Editor Dr. Kei Sano is the representative director of KYTK, a private company that receives compensation for his services as a team physician. The company’s activities are unrelated to the subject matter of this Research Topic. The other Topic Editors declare no competing interests with regard to the Research Topic subject Topic editors: Kei Sano, Youngji Kim Source: https://www.frontiersin.org/research-topics/86806/skin-microbiome-and-surgical-site-considerations-in-orthopedic-and-arthroplasty-surgery