Incidence and risk factors for deep surgical site infection after open reduction and internal fixation of closed tibial plateau fractures in adults

Abstract

This study aimed to investigate the incidence and risk factors of deep surgical site infection (DSSI) during hospitalisation after closed tibial plateau fractures treated with open reduction and internal fixation (ORIF). We performed this retrospective study at a university-affiliated hospital with an advanced trauma centre. The data of adult patients with closed tibial plateau fractures treated with ORIF from January 2012 to February 2017 were extracted from the electronic medical records. Demographics, injury-related and surgery-related variables of DSSI and non-DSSI groups were compared by univariate test. Multivariate logistic analysis models were used to investigate the independent risk factors. In total, 676 patients with complete data met the inclusion criteria and were included, and of them, 17 developed DSSI (2.51%) during hospitalisation. Approximately 60% (9/17) of DSSI was caused by Staphylococcus aureus. Compared to the non-DSSI group, DSSI patients had a significantly longer stay in hospital (25.8 vs 15.2 days). Independent risk factors of DSSI identified by multivariate analysis were higher BMI (>26.0) (OR, 1.58; 95% CI, 1.09 to 3.27; P = 0.032), prolonged surgical duration (>138 min) (OR, 4.26; 95% CI, 1.54 to 11.19; P = 0.005) and current smoking (OR, 3.42; 95% CI, 1.47 to 8.62; P = 0.01). A relatively low incidence rate of DSSI (2.51%) was found in this study, and several significant risk factors were identified. Smoking cessation programmes should be implemented immediately after hospitalisation, especially for obesity and morbid obesity patients. Detailed and comprehensive preoperative assessment and a considerate operative plan should be guaranteed to reduce surgical duration.

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures

“…Following the removal of duplicate studies, a total of 4472 studies were available for title and abstract screening (Figure 1). With our inclusion criteria applied and relevant reference lists screened, 117 studies 1,2,4,5,10,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,…”

Incidence and risks for surgical site infection after closed tibial plateau fractures in adults treated by open reduction and internal fixation: a prospective study

“…Previous studies had been conducted to investigate the incidence and related risk factors of SSI, including the extended operation time, smoking status, open fracture type, higher level of fracture type (Schatzker types IV-VI), and so on [5][6][7][8]. However, most previous researches were designed as a retrospective, which might have limitations inaccuracy of data collection and obscure follow-up information.…”

“…Among the complications, SSI was the most common one. Previous literature had reported that SSIs developed at 2–14.2% of patients after they underwent ORIF, half of which were deep infections [ 5 – 7 ]. Consequently, patients had to be re-admitted or even re-operated to replace or remove internal fixtures to treat the infection.…”

Incidence and risks for surgical site infection after closed tibial plateau fractures in adults treated by open reduction and internal fixation: a prospective study

“…[2][3][4], Among the complications, SSI was the most common one. Previous literature had reported that SSIs developed at 2-14.2% of patients after they underwent ORIF, half of which were deep infections [5][6][7]. Consequently, patients had to be re-admitted, or even re-operated to replace or remove internal fixtures to treat the infection.…”

“…Previous studies had been conducted to investigate the incidence and related risk factors of SSI, including the extended operation time, smoking status, open fracture type, higher level of fracture type (Schatzker types IV-VI), and so on [5][6][7][8]. However, most previous researched were designed as retrospective, which might have limitations inaccuracy of data collection and obscure follow-up information.…”