Prevalence of Surgical Site Infection in Orthopedic Surgery: A 5-year Analysis

Almulhim, Fahad; Baragbah, Mohammed A.; Sadat-Ali, Mir; Al-Omran, Abdallah S; Azam, Quamar

doi:10.9738/intsurg-d-13-00251.1

Cited by 123 publications

(124 citation statements)

References 22 publications

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“…The prevalence of SSI in the current study is higher than that reported by other authors 2,3,4,6,7,8,9,10 . However, similar prevalence of SSI was observed in other studies done by 1,12, .…”

Section: Discussioncontrasting

confidence: 55%

“…There is a direct relationship between development of surgical site infection and the length of surgery. Orthopaedic surgeries done for more than 2 hours are at higher risk of infection 3,7,10,11,12,13,14 . Similar finding was noted in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical site infection (SSI) is the infection which occurs within 30 days after surgery or one year if implant left in the site after procedure (5,-7,) . Worldwide, orthopaedic SSI rates range between 1.4 and 41.9% 3,8 . Surgical site infections in orthopedic practice can have significant effects on quality of life for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…These include appropriate timing of prophylactic antibiotics administration at about 30 minutes prior incision, use of appropriate antiseptic agents and techniques for surgical site skin preparation, reduction of movements and number of staff in the operating rooms and protection of incision site with sterile dressings 3,5,6 . Little is known about the magnitude and risk factors for SSIs among orthopaedic cases in our environment as a limited number of studies about SSIs have been conducted in Tanzania which mainly based on general surgical patients 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Surgical site infections (SSIs) in orthopaedic surgery are globally common and continue to be a major problem among orthopaedic patients [1][2][3] . A surgical site infection is clinically defined as presence of pain at a surgically created wound, which is accompanied by erythema, induration and local tenderness or presence of purulent discharge at wound site 1,4 .…”

Section: Introductionmentioning

confidence: 99%

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Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania

Kisibo¹,

Ndume²,

Semiono³

et al. 2017

East. Cent. Afr. J. Surg.

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Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania

Kisibo¹,

Ndume²,

Semiono³

et al. 2017

East. Cent. Afr. J. Surg.

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Combating Implant Infections: Shifting Focus from Bacteria to Host

et al. 2020

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commensal skin bacteria, Staphylococci, and in particular Staphylococcus aureus, have a strong tendency to colonize foreign bodies and cause IAI. [3,4] Important for the underlying pathophysiology, Staphylococci are highly competent at producing biofilms on implant surfaces, which encapsulate the bacterial niche from the outside environment, [5,6] thereby protecting the bacteria from host defense systems and antibiotics. [7] Antibiotics are administered as a routine procedure. [8] However, as a consequence of widespread antibiotics usage, bacteria are exposed to subinhibitory concentrations of antibiotics at a larger scale, driving their development toward antibiotic resistance, [9] as illustrated by the emergence of methicillin-resistant S. aureus (MRSA). [10,11] As an improvement over current clinically applied local antibiotics delivery systems, [12] the recent developments in implant surface engineering approaches allow better antimicrobial functionalities to be incorporated to allow for more tunable and controlled drug release. [13-15] The "race to the surface" model is popular among biomaterials researchers to predict the biomaterials fate, resulting from the competition between eukaryotic cells and bacteria at the material surface. [16] Using this template, implant antibacterial properties are being stemmed from direct contact killing mechanisms due to implant surface modifications [17,18] or firm immobilization of drugs, [19,20] as they both "shield" the implant from bacterial adhesion. The current anti-infective biomaterials strategies being explored can be categorized as: 1) implant functionalization with antibiotics or antibacterial drugs such as host defense peptides (HDPs), inorganic materials (e.g., chitosan and derivatives), and inorganics (e.g., silver, copper, and zinc metal nanoparticles (NPs)), 2) anti-biofilm surface modification (e.g., coating with antifouling polymers or quorum sensor inhibitors), or 3) physical surface changes for direct contact-killing properties (e.g., nanotubes, nanopillars, and metal implantation). [15,21] Emerging as a serious alternative or adjuvant therapy to antibiotics, bacteriophage (phage) therapy uses viruses responsible for the lysis of specific bacterial strains. [22,23] As a natural predator of bacteria, phages employ different killing mechanisms, making multidrug resistant bacteria susceptible for phages. [24] Moreover, phages are highly specific for pathogenic cells, which can eliminate disastrous off-target effects in the host. [25] As a limitation, the use of phage cocktails is needed for therapeutic efficacy, [26] while there is currently is no conclusive data on possible long-term side effects of phage therapy in The widespread use of biomaterials to support or replace body parts is increasingly threatened by the risk of implant-associated infections. In the quest for finding novel anti-infective biomaterials, there generally has been a one-sided focus on biomaterials with direct antibacterial properties, which leads to excessive use of antibacterial ag...

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2018 International Consensus Meeting on Musculoskeletal Infection: Research Priorities from the General Assembly Questions

Schwarz

Parvızı

Gehrke

et al. 2019

Journal Orthopaedic Research

218

200

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Musculoskeletal infections (MSKI) remain the bane of orthopedic surgery, and result in grievous illness and inordinate costs that threaten healthcare systems. As prevention, diagnosis, and treatment has remained largely unchanged over the last 50 years, a 2nd International Consensus Meeting on Musculoskeletal Infection (ICM 2018, https://icmphilly.com) was completed. Questions pertaining to all areas of MSKI were extensively researched to prepare recommendations, which were discussed and voted on by the delegates using the Delphi methodology. The questions, including the General Assembly (GA) results, have been published (GA questions). However, as critical outcomes include: (i) incidence and cost data that substantiate the problems, and (ii) establishment of research priorities; an ICM 2018 research workgroup (RW) was assembled to accomplish these tasks. Here, we present the result of the RW consensus on the current and projected incidence of infection, and the costs per patient, for all orthopedic subspecialties, which range from 0.1% to 30%, and $17,000 to $150,000. The RW also identified the most important research questions. The Delphi methodology was utilized to initially derive four objective criteria to define a subset of the 164 GA questions that are high priority for future research. Thirty-eight questions (23% of all GA questions) achieved the requisite > 70% agreement vote, and are highlighted in this Consensus article within six thematic categories: acute versus chronic infection, host immunity, antibiotics, diagnosis, research caveats, and modifiable factors. Finally, the RW emphasizes that without appropriate funding to address these high priority research questions, a 3rd ICM on MSKI to address similar issues at greater cost is inevitable. ICM, International Consensus Meeting; MSKI, musculoskeletal infections; RW, research workgroup. * 2018 ICM RW consensus on the current and projected incidences of infection, and costs per patient, for all orthopedic subspecialties. These estimates, which were compiled from information were obtained from: (i) recent peer-reviewed publications, (ii) analysis of 2015 national administrative data using HCUPNet (https://hcupnet.ahrq.gov/#setup), and (iii) RW expertise. 998 SCHWARZ ET AL.

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Prevalence of Surgical Site Infection in Orthopedic Surgery: A 5-year Analysis

Cited by 123 publications

References 22 publications

Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania

Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania

Combating Implant Infections: Shifting Focus from Bacteria to Host

2018 International Consensus Meeting on Musculoskeletal Infection: Research Priorities from the General Assembly Questions

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