Predictors of Deep Infection After Distal Femur Fracture: A Multicenter Study

Brodke, Dane J; O’Hara, Nathan N.; Devana, Sai; Hernandez, Adolfo; Burke, Cynthia E.; Gupta, Jayesh; McKibben, Natasha S; O’Toole, Robert V.; Morellato, John; Gillon, Hunter; Walters, Murphy; Barber, Colby; Perdue, Paul; DeKeyser, Graham J.; Steffenson, Lillia; Marchand, Lucas S.; Fairres, Marshall James; Black, Loren O.; Working, Zachary M; Roddy, Erika; Naga, Ashraf El; Hogue, Matthew; Gulbrandsen, Trevor R.; Atassi, Omar; Mitchell, Thomas; Shymon, Stephen; Lee, Christopher

doi:10.1097/bot.0000000000002514

Cited by 2 publications

(8 citation statements)

References 38 publications

(53 reference statements)

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“…Twenty‐three studies were removed owing to improper research design or outcomes, and 22 studies were discarded due to a lack of necessary data after carefully examining the full text of 55 studies. Finally, this systematic review and meta‐analysis included 12 studies 8–10,19–27 …”

Section: Resultsmentioning

confidence: 99%

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Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta‐analysis

Asadi

Tehrany

Salari

et al. 2023

International Wound Journal

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The goal of this systematic review and meta‐analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as “Prevalence”, “Surgical wound infection”, “Surgical site infection” and “Orthopedics” from the earliest to the May 1, 2023. The appraisal tool for cross‐sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%–7.2%; I2 = 99.39%; p < 0.001). The pooled prevalence of surgical wound infection in male and female patients who underwent long bone surgery was 4.6% (95% CI: 1.7%–11.7%; p < 0.001; I2 = 99.34%) and 2.6% (95% CI: 1.0%–6.3%; I2 = 98.84%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with femur surgery sites reported in nine studies was 3.7% (95% CI: 2.1–6.4%; I2 = 93.43%; p < 0.001). The pooled prevalence of surgical wound infection in open and close fractures was 16.4% (95% CI: 8.2%–30.2%; I2 = 95.83%; p < 0.001) and 2.9% (95% CI: 1.5%–5.5%; I2 = 96.40%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) was 4.6% (95% CI: 2.3%–8.9%; I2 = 81.50%; p < 0.001), 2.7% (95% CI: 1.2%–6.0%; I2 = 83.82%; p < 0.001) and 3.0% (95% CI: 1.4%–6.4%; I2 = 69.12%; p = 0.006), respectively. In general, the different prevalence of surgical wound infection in patients undergoing surgical treatment after long bone fracture may be caused by underlying factors (gender and co‐morbidity) and fracture‐related factors (surgery site and type of fracture).

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Section: Resultsmentioning

confidence: 99%

“…As shown in Table 1, a total of 71 854 patients undergoing long bone surgery participated in 12 studies 8–10,19–27 . Their mean age was 57.89 (SD = 16.51), and 57.79% of them were women.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta‐analysis

Asadi

Tehrany

Salari

et al. 2023

International Wound Journal

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“…This increased incidence has been described in other cases. Incidences of 11% have been described in distal femur fractures 3 and of 21% in cases of tibial pilon fractures. 29 Lawrenz et al 10 describe a 29% infection rate of E cloacae in healed fractures after internal fixation, none of which were ankle fractures.…”

Section: Discussionmentioning

confidence: 99%

“…They are also observed in patients with a prolonged hospital stay and antibiotic treatment, especially in intensive care units. 4,20 In traumatology, its incidence has been reported in chronic osteomyelitis, 7,19,28 prosthetic infections, 2,5 septic osteoarthritis, 6 open traumatism in children 11 and adults, 30 and in fractures 3,29 other than the ankle.…”

Section: Introductionmentioning

confidence: 99%

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Enterobacter cloacae Infection After Surgical Treatment of Ankle Fractures, a Multicenter Observational Study

et al. 2023

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Background: Infection is one of the challenging complications after open reduction and internal fixation for ankle fractures. Previously published case series conclude that Staphylococcus aureus is the most frequent causative microorganism. An unexpected increase in Enterobacter cloacae infections after this surgery was observed in a preliminary analysis of data at the promoting center of the study. In traumatology, its incidence has been reported in chronic osteomyelitis, prosthetic infections, septic osteoarthritis, open fractures in children and adults, and fractures other than the ankle. Because of this unexpected finding, we decided to perform this study to analyze the demographic and microbiological variables of acute osteosynthesis infection after ankle fracture and determine the distinctive features of the patients with E cloacae infection. Methods: We performed a retrospective multicenter study including 4 university hospitals. All patients diagnosed with acute osteosynthesis infection after ankle fracture fixation between January 2015 and December 2018 were included. We analyzed demographic data, type of fracture, surgical technique, and microorganisms responsible for the infection. We performed a descriptive statistical analysis of the variables. Univariate and multivariate regression analysis were performed to compare patients with E cloacae infection to patients with infection caused by other microorganisms. Results: A total of 65 patients were included. A predominance of polymicrobial infections (24.62%), followed by infections caused by S aureus (23.07%) and E cloacae (23.07%) was observed. When E cloacae isolated in polymicrobial infections were added, the incidence of E cloacae as a causative microorganism increased to 32.3%. Patients with E cloacae infection were older (64/53, P = .008) and had a higher requirement of negative-pressure therapy after surgical debridement (71%/40%, P = .017). Conclusion: A high incidence of E cloacae infections was observed. Patients with E cloacae infection were generally older and required a higher use of negative-pressure therapy after debridement. Level of Evidence: Level V, mechanism-based reasoningr.

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Predictors of Deep Infection After Distal Femur Fracture: A Multicenter Study

Cited by 2 publications

References 38 publications

Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta‐analysis

Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta‐analysis

Enterobacter cloacae Infection After Surgical Treatment of Ankle Fractures, a Multicenter Observational Study

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