Incidence and risk factors for surgical site infection following elective foot and ankle surgery: a retrospective study

Meng, Jinghong; Zhu, Yanbin; Li, Yansen; Sun, Tao; Zhang, Fengqi; Qin, Shiji; Zhao, Haitao

doi:10.1186/s13018-020-01972-4

Cited by 18 publications

(16 citation statements)

References 31 publications

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“… 17 Infection rates following elective foot and ankle surgery are low, ranging from 2.1–3.6% in the literature. 21 , 22 It is unclear why our lack of surgical site infection in the current study varies from that in our 2013 study. However, due to our small cohort of patients, it is not entirely unexpected.…”

Section: Discussioncontrasting

confidence: 58%

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Miner

Protzman

Brigido

2022

Scars, Burns & Healing

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Introduction Silver hydrogel dressings are antimicrobial dressings with the potential to aid post-surgical healing. The purpose of this study is to evaluate the effects of a silver hydrogel dressing on postoperative scarring and complications. Methods 40 foot and ankle patients (48.43 ± 16.82 years) were included in the study with 20 patients in each group. Postoperatively, the treatment group was treated with a silver hydrogel sheet dressing, and the control group was treated with a standard petroleum-based dressing. Follow-up was performed at two, six, and 12 weeks. Postoperative scarring and complications were evaluated and compared between groups. Scarring was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). Scar length and width were measured using digital calipers and used to compute scar area. Results The treatment group demonstrated statistically significant improvements in the POSAS observer score and observer opinion at six and 12 weeks ( p < 0.001). Additionally, patient reported pain was significantly lower for the treatment group than the control group at 12 weeks ( p < 0.001). Patient reported itch declined across time for both groups ( p < 0.001) with significantly less itching reported by the treatment group ( p = 0.027). Scar area was also significantly lower for the treatment group than the control group at six weeks and 12 weeks ( p ≤ 0.002). Neither group experienced any postoperative complications. Conclusion These results suggest that the inherent properties of the silver hydrogel dressing may improve postsurgical scarring. Lay Summary Surgical incisions result in scar, which can present both cosmetic and rehabilitation concerns after foot or ankle surgery. It is standard to use a petroleum-based dressing on incisions after surgery, however, advancements in incisional dressings have been made over the past 20 years. One such advancement is silver-impregnated hydrogel sheet dressings which have been shown to maintain a moist wound environment conducive to healing, while decreasing the chance of infection through its antimicrobial properties. This paper evaluates scar healing after foot or ankle surgery in patients treated with either the standard petroleum-based dressing, or the silver hydrogel sheet dressing. Patients who were treated with the silver hydrogel dressing had less itching and pain, as well as a smaller scar area than patients in the standard dressing group. Therefore, our results suggest that the silver hydrogel dressing may improve scarring after surgery.

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Section: Discussioncontrasting

confidence: 58%

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Miner

Protzman

Brigido

2022

Scars, Burns & Healing

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“…23,24 We always follow strict theatre protocols, a standard antibiotic policy, involvement of local microbiologist and a close surveillance on our patients helped us to keep SSI comparable with international standards. Few other Non-quantifiable factors, such as length of operating time, prophylactic use of antibiotic and protocol for skin preparation have been found important in other studies 17,25,26,27 .Our study looked at our orthopedic theatres infection rate and our SSI rate give us an encouraging picture to continue good practice and improve it further.…”

Section: Discussionmentioning

confidence: 64%

Incidence of Surgical Site Infection in Patients Presented for Orthopaedic Surgery

Bilal¹,

Karamat²,

Basit³

et al. 2022

PJMHS

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Objective: To find out the incidence of surgical site infection in clean cases of orthopaedic surgery. Study design: Retrospective descriptive study. Setting: Trauma and orthopaedic unit Gulab Devi Hospital. Duration: April 2018 to November 2021 Methodology: Using non probability (purposive) sampling a total of 800 patients who underwent an invasive surgical procedure during the specified time period was included in the study. While all non-invasive procedures such as manipulations, application of plaster casts and image guided intra-articular injections were excluded from study. p-value< 0.05 was considered as significant Results: There were 504(63%) male patients and 296(37%) female patients. Age range was between 01 to 86 years. Mean age was 30±6.7 years. After performing surgery, all patients were followed up for minimum of four weeks to record SSIs. Post-operatively infection was detected in 17(2.12%) of our patients. SSI was 5.8% in clean cases, 23.5% in clean contaminated and 70.5% in dirty cases. The prevalence of SSI were significantly higher in those patients already having dirty wound before procedure as p<0.05 Conclusion: Surgical Site infection (SSI) rates reported in this study setting are are comparable to international standards. Keywords: Orthopedic, Surgical site infections, Trauma, Wound management

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“…NEU was generally considered an SSI risk factor [ 22 , 44 , 45 ]. In this study's univariate analysis, the difference in NEU between the SSI and non-SSI groups was statistically significant; however, the multivariate analysis failed to identify NEU as an SSI predictor.…”

Section: Discussionmentioning

confidence: 99%

Predictors for surgical site infection after fasciotomy in patients with acute leg compartment syndrome

et al. 2023

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Background Surgical site infection (SSI) is one of the most common complications of orthopedic surgery, which can result in fever, pain, and even life-threatening sepsis. This study aimed to determine the predictors of SSI after fasciotomy in patients with acute leg compartment syndrome (ALCS). Methods We collected information on 125 ALCS patients who underwent fasciotomy in two hospitals between November 2013 and January 2021. Patients with SSI were considered as the SSI group and those without SSI as the non-SSI group. Univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analyses were used to evaluate patient demographics, comorbidities, and admission laboratory examinations. Results In our research, the rate of SSI (26 of 125) was 20.8%. Several predictors of SSI were found using univariate analysis, including body mass index (BMI) (p = 0.001), patients with open fractures (p = 0.003), and patients with a history of smoking (p = 0.004). Besides, the levels of neutrophil (p = 0.022), glucose (p = 0.041), globulin (p = 0.010), and total carbon dioxide were higher in the SSI group than in the non-SSI group. According to the results of the logistic regression analysis, patients with open fractures (p = 0.023, OR 3.714), patients with a history of smoking (p = 0.010, OR 4.185), and patients with a higher BMI (p = 0.014, OR 1.209) were related predictors of SSI. Furthermore, ROC curve analysis indicated 24.69 kg/m2 as the cut-off value of BMI to predict SSI. Conclusions Our results revealed open fractures, BMI, and smoking history as independent risk factors for SSI following fasciotomy in patients with ALCS and determined the cut-off value of BMI, enabling us to individualize the evaluation of the risk for SSI to implement early targeted treatments.

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Incidence and risk factors for surgical site infection following elective foot and ankle surgery: a retrospective study

Cited by 18 publications

References 31 publications

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Incidence of Surgical Site Infection in Patients Presented for Orthopaedic Surgery

Predictors for surgical site infection after fasciotomy in patients with acute leg compartment syndrome

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