Refractory Infection After Internal Fixation for Rib Fractures

Gao, Erji; Zhang, Xufeng; Han, Min-Gu; Zhang, Yongkai; Zhao, Chuncheng; Wang, Zheng; Guo, Zhiqiang

doi:10.1016/j.athoracsur.2019.10.090

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…The current study's incidence of SSI after SSRF was similar to a previous report [12]. To date, studies on surgical site or implant infection after SSRF are limited to case reports or series that only describe infection in the acute setting [13,14,17]. In the acute setting, antibiotic bead placement and vacuum-assisted closure is suggested to bridge time to union, until implant removal can be done after the rib fracture site has healed [11,13,14].…”

Section: Discussionsupporting

confidence: 79%

Surgical Site Infection after Surgical Stabilization of Rib Fractures: Rare but Morbid

Prins

Leasia

Dull

et al. 2022

Surgical Infections

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Background: Although surgical stabilization for rib fractures (SSRF) has been adopted widely over the past decade, little information is available regarding the prevalence and outcomes of post-operative surgical site infection (SSI). We hypothesized that SSI after SSRF is uncommon but morbid. Patients and Methods: Patients undergoing SSRF at a level 1 trauma center from 2010-2020 were reviewed. The primary outcome was the prevalence of SSI, documented by clinical examination, radiography, systemic markers of infection, and microbiology. Results: Of 228 patients undergoing SSRF, 167 (73.2%) were male, the median age was 53 years (P 25 -P 75 ; 41-63 years), injury severity score (ISS) was 19 (P 25 -P 75, 13-26), with a median of eight fractured ribs (P 25 -P 75, 6-11). All stabilization plates were titanium. SSRF was typically performed on post-injury day one (P 25 -P 75, 0-2 days) after trauma. All patients received antibiotic agents within 30 minutes of incision, and a median of four ribs (P 25 -P 75, 3-6) were repaired. Four (1.8%) patients developed an SSI and all underwent implant removal. Two patients required implant removal within 30 days (on post-operative day seven and 17) and two for chronic infection at seven and 17 months after SSRF. The causative organism was methicillin-sensitive Staphylococcus aureus (MSSA) bacteria in all patients. After implant removal, three patients received intravenous and oral antibiotic agents, ranging from two to six weeks, without recurrent infection. No patient required additional SSRF. Conclusions: Surgical site infection after SSRF is rare but morbid and can become symptomatic within one week to 17 months. Implant removal results in complete recovery.

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Section: Discussionsupporting

confidence: 79%

Surgical Site Infection after Surgical Stabilization of Rib Fractures: Rare but Morbid

Prins

Leasia

Dull

et al. 2022

Surgical Infections

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“…2 The optimal management of rib fractures in conjunction with concomitant chest wounds has been the subject of debates since the inception of surgical techniques. [11][12][13][14][15][16][17] External stabilization methods that provide support for the thoracic girdle are now being compared in terms of efficacy with internal fixation methods. 18 Internal fixation frequently employs minimally invasive techniques like the auscultatory triangle approach.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of wound outcomes and surgical strategies: Internal fixation versus external stabilization in rib fracture patients with traumatic chest wounds

Wang,

Wang

et al. 2023

International Wound Journal

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The clinical management of traumatic chest incisions accompanied by rib fractures presents the formidable challenge. The study was carried out to compare the outcomes of auscultatory triangle internal fixation (ATIF) and external fixation (EF) in such injuries. From June 2019 to June 2022, 105 patients with multiple rib fractures participated in the cohort study in which they were divided into two groups: 53 patients underwent ATIF and 52 patients underwent EF. The incidence of surgical site infection, wound healing time, incidence of wound dehiscence, number of dressing changes, pain as measured by the visual analogue scale (VAS), duration of hospitalization, period of return to work, pulmonary complications and functionality of the upper limbs as assessed by the Disability of Arm, Shoulder, and Hand (DASH) questionnaire were among the parameters evaluated. In comparison with EF, ATIF demonstrated the decreased incidence of wound dehiscence (1.9% vs. 9.6%) (p < 0.05), surgical site infection (3.8 vs. 11.5) and wound healing time (12.3 ± 2.1 vs. 18.5 ± 3.7 days) (p < 0.05). Furthermore, during their ATIF treatment, patients required fewer changes of dressing (3.5 ± 0.8 vs. 5.7 ± 1.2) and demonstrated enhanced pain management, reduced hospital stays and expedited return to work (p < 0.05). ATIF group demonstrated enhancements in both upper limb functionality and post‐operative pulmonary function (p < 0.05). The utilization of ATIF as opposed to EF for the treatment of traumatic chest wounds accompanied by rib fractures yields superior outcomes in terms of wound healing, infection reduction and restoration of pulmonary and upper limb functionality.

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Chest Wall Injury Society Recommendations for Management of Surgical Site or Implant-Related Infections After Surgical Stabilization of Traumatic Rib or Sternal Fractures

Forrester

Faliks

Cardarelli

et al. 2023

Surgical Infections

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Refractory Infection After Internal Fixation for Rib Fractures

Cited by 3 publications

References 6 publications

Surgical Site Infection after Surgical Stabilization of Rib Fractures: Rare but Morbid

Surgical Site Infection after Surgical Stabilization of Rib Fractures: Rare but Morbid

Comparative study of wound outcomes and surgical strategies: Internal fixation versus external stabilization in rib fracture patients with traumatic chest wounds

Chest Wall Injury Society Recommendations for Management of Surgical Site or Implant-Related Infections After Surgical Stabilization of Traumatic Rib or Sternal Fractures

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