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

Norris, Grayson R.; Checketts, Jake X.; Scott, Jared; Vassar, Matt; Norris, Brent; Giannoudis, Peter V.

doi:10.1001/jamanetworkopen.2019.9951

Cited by 39 publications

(40 citation statements)

References 130 publications

(557 reference statements)

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“…weight, smoking, previous illnesses) and fracture-or operation-dependent factors (e.g. fracture morphology, compartment syndrome, polytrauma) [16][17][18]. Furthermore, the exact mechanism on how fracturoscopy has a positive effect on reducing SSI remains unclear; possible factors may include low operative complication rates such as lower blood loss and smaller operative approach with less soft tissue damage.…”

Section: Discussionmentioning

confidence: 99%

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Henkelmann¹,

Krause

Alm³

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Surgical treatment of tibial plateau fracture (TPF) is common. Surgical site infections (SSI) are among the most serious complications of TPF. This multicentre study aimed to evaluate the effect of fracturoscopy on the incidence of surgical site infections in patients with TPF. Methods We performed a retrospective multicentre study. All patients with an AO/OTA 41 B and C TPF from January 2005 to December 2014 were included. Patients were divided into three groups: those who underwent arthroscopic reduction and internal fixation (ARIF), and those who underwent open reduction and internal fixation (ORIF) with fracturoscopy, and those treated with ORIF without fracturoscopy. The groups were compared to assess the effect of fracturoscopy. We characterised our cohort and the subgroups using descriptive statistics. Furthermore, we fitted a logistic regression model which was reduced and simplified by a selection procedure (both directions) using the Akaike information criterion (AIC). From the final model, odds ratios and inclusive 95% confidence intervals were calculated. Results Overall, 52 patients who underwent fracturoscopy, 48 patients who underwent ARIF, and 2000 patients treated with ORIF were identified. The rate of SSI was 0% (0/48) in the ARIF group and 1.9% (1/52) in the fracturoscopy group compared to 4.7% (93/2000) in the ORIF group (OR = 0.40, p = 0.37). Regression analyses indicated a potential positive effect of fracturoscopy (OR, 0.65; 95% CI, 0.07–5.68; p = 0.69). Conclusion Our study shows that fracturoscopy is associated with reduced rates of SSI. Further studies with larger cohorts are needed to investigate this. Level of evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Henkelmann¹,

Krause

Alm³

et al. 2020

Eur J Trauma Emerg Surg

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“…Patient‐related risk factors, such as age, DM, obesity, tobacco use, alcohol use, and immunosuppression can play an important role in the development of SSI 43 . Norris et al 56 completed a systematic review on SSI incidence after knee fracture repair and noted that patients with a history of smoking, diabetes, or compartment syndrome are at greater risk for development of an SSI. This may be related to impaired microvascular blood flow and inadequate ability to transport antibiotics or necessary white blood cells to fight an infection.…”

Section: Discussionmentioning

confidence: 99%

The Role of Perioperative Hypothermia in the Development of Surgical Site Infection: A Systematic Review

Cengiz¹,

Uçar²,

Yilmaz³

2021

AORN Journal

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Surgical patients may experience inadvertent perioperative hypothermia, a condition that can cause a variety of complications, including surgical site infection (SSI). The authors of this systematic review used the Preferred Reporting Items for Systematic Review and Meta‐Analysis Protocols guidelines to examine the role of perioperative hypothermia in the development of SSI. The authors searched the PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane, and ScienceDirect databases for eligible articles published between January 2008 and November 2018 and identified seven studies that met the inclusion criteria. The results of this review indicate that the relationship between hypothermia and SSI is closely related to the type of the surgical intervention performed (eg, emergent, colorectal), and that severe hypothermia (eg, <35.0° C [95.0° F]) can increase the risk of developing an SSI. Perioperative nurses should monitor patients for inadvertent hypothermia and prevent its occurrence when possible.

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“…Overall the reported incidence of CS following tibial plateau fracture ranges from 0.7 to 12% [26,29,[50][51][52][53]. Although a somewhat controversial topic with conflicting findings in the literature, acute compartment syndrome requiring fasciotomy has been reported in some studies to significantly increase the rate of non-unions [27] and infections [27,[54][55][56]. On the other hand, Ruffalo et al [57] found no increase in the association of nonunion and infection.…”

Section: Compartment Syndromementioning

confidence: 99%

“…A 2019 meta-analysis including 7925 patients found the incidence of superficial and deep surgical site infections after tibial plateau fracture repairs to be 4.2% and 5.9%, [54][55][56]125], compartment syndrome [27,[54][55][56], smoking [55,56,125], alcohol intake [126], definitive external fixation [56,94] and intraoperative duration approaching 3 h [54,56,125]. A recent article found a strong correlation between a significantly higher peak of C-reactive protein (CRP) >100 μg/ mL on postoperative day 3 and the development of surgical site infections in tibial plateau patients [127].…”

Section: Surgical Site Infectionmentioning

confidence: 99%

Tibial Plateau Fracture

Schmidt¹,

Szatkowski²,

Riehl³

2020

Tibia Pathology and Fractures

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Tibial plateau fractures are a common orthopedic injury. These fractures involve the articular surface of the tibia that is part of the knee joint. Plateau fractures can range from low energy injuries with little or no displacement to complex fractures with significant associated injuries. Stability of these injuries depends on a combination of bony and associated ligamentous injuries. Treatment consists of a wide spectrum of therapies which have been discussed in this chapter. Complications such as compartment syndrome, post-traumatic arthritis, chronic pain, malunion, and wound problems (in addition to other complications) can develop.

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

Cited by 39 publications

References 130 publications

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

The Role of Perioperative Hypothermia in the Development of Surgical Site Infection: A Systematic Review

Tibial Plateau Fracture

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