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

Abstract

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).

Prevalence of surgical site infection and risk factors in patients after knee surgery: A systematic review and meta‐analysis

“… 3 The findings from another systematic review and meta‐analysis revealed that the occurrence of SSI among patients following long bone surgery is 3.3%. 11 The variance in the prevalence of orthopaedic SSI between our study and these previous investigations can be attributed to the differences in surgical site locations. In 2019, a systematic review and meta‐analysis were undertaken to examine the incidence of deep SSI following periarticular knee fracture repair.…”

“…In orthopaedic surgery, a surgical site infection (SSI) is characterized as an infection that develops within 30 days following surgery when no fixation devices have been implanted, or within 1 year if a metallic device remains implanted. 1 , 2 , 3 , 4 SSI represents a prevalent complication in both orthopaedic and various other surgical procedures. The elevated incidence of SSI can be attributed to factors such as the expanding range of orthopaedic indications, the intricate nature of orthopaedic surgeries and the frequent use of implants in these procedures.…”

“…It may encompass structures such as muscles, fascia, or in certain cases, joints and bones, contingent upon the specific surgical procedure. 9 , 10 , 11 …”