Risk Factors of Surgical Site Infection after Acetabular Fracture Surgery

Li, Qinghu; Liu, Ping; Wang, Guodong; Yang, Yongliang; Dong, Jinlei; Wang, Yonghui; Zhou, Dongsheng

doi:10.1089/sur.2014.134

Cited by 35 publications

(18 citation statements)

References 30 publications

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“…We found many factors associated with SSI after acetabular fracture surgery such as the prolonged operative time 9) , high BMI 10) , prolonged ICU stay 11) , high rate of PRBC 12) , and associated abdominal and genitourinary trauma 13) .…”

Section: Discussionmentioning

confidence: 96%

“…In our study associated injury such as abdominal injury (splenic injury) and genitourinary trauma (bladder injury) also had positive influence on SSI. Li et al 13) reported in his study that abdominal trauma and urinary tract trauma are commonly associated with SSI following acetabular fracture fixation. Hence, special attention must be made while treating associated injuries to reduce the incidence of SSI.…”

Section: Discussionmentioning

confidence: 98%

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Surgical Site Infection Following Fixation of Acetabular Fractures

et al. 2017

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PurposeAcetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances.Materials and MethodsA total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries.ResultsFourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma.ConclusionIn our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Surgical Site Infection Following Fixation of Acetabular Fractures

et al. 2017

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“…They are caused by bacteria that invade through the incisions during surgery and may develop near the skin surface around an incision or deep in the surgical wound, thus representing serious complications [18]. Risk factors for surgical site infections include extended preoperative hospitalization, massive intraoperative blood loss, larger amount of packed red blood cell unit transfused, and prolonged surgery time [18, 19]. …”

Section: Introductionmentioning

confidence: 99%

Results of 167 consecutive cases of acetabular fractures using the Kocher-Langenbeck approach: a case series

Negrin

Seligson

2017

J Orthop Surg Res

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BackgroundAcetabular fractures are quite challenging injuries for the orthopedic surgeon because of their low incidence and their deep and complex anatomy. The objective of this study was to evaluate surgeon-independent parameters that might influence radiographic outcome and early complication rates of high-energy acetabular fractures treated by open reduction and internal fixation via the Kocher-Langenbeck approach, the golden standard for posterior access.MethodsOne hundred sixty-seven consecutive patients (111 males and 56 females) with a mean age of 41.8 years and a mean follow-up period of 10 months were surgically treated by one experienced surgeon at a level I trauma center within 10 years. To quantify the radiographic outcome, the Matta, Brooker, and Epstein grades were used. Posttraumatic arthritis and avascular necrosis of the femoral head (defined as Helfet grades 3 or 4 and Ficat/Arlet stages 3 or 4, respectively) were evaluated. Furthermore, subgroup analyses according to fracture type, age, and gender were performed for each outcome measure and complication (infection, hemorrhagic shock, revision surgery, nerve damage, and need of a total hip arthroplasty).Results65 A1, 34 A2, 51 B1, and 17 B2 fractures were identified according to the AO/ASIF classification. Of all patients, reduction was rated anatomic in 63.5%, imperfect in 22.2%, and poor in 14.4%. Degenerative changes were observed in 49.7%; 37.9% were affected by heterotopic ossification, 21.6% by posttraumatic arthritis, and 5.4% by avascular necrosis of the femoral head. Fifteen percent were diagnosed with a nerve damage, and 4.8% sustained an infection. Total hip arthroplasty was performed in 10.2%. Revision surgery due to secondary loss of reduction, seroma/hematoma, and wound infection was indicated in 6.0%.ConclusionsFracture type, age, and gender are prognostic factors for the surgical outcome after ORIF of high-energy acetabular fractures.Electronic supplementary materialThe online version of this article (doi:10.1186/s13018-017-0563-6) contains supplementary material, which is available to authorized users.

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“…First, it is a relatively easy anatomical dissection involving fewer anatomical layers than Stoppa ( Figure 10 ). The duration of surgical exposure is another factor related to infection [ 3 , 25 ]. We think this easy and time-saving approach can play a role in preventing infection by shortening this procedure time.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach for Treatment of Acetabular Fractures

et al. 2016

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BackgroundThere is no single approach that provides adequate exposure for treatment of all types of acetabular fractures. We describe our experience with an easier, relatively less invasive pubic symphysis approach (PSA) for the treatment of acetabular fractures.Material/MethodsBetween March 2011 and March 2012, fifteen patients with acetabular fracture underwent surgery using the PSA technique. Fracture reduction and treatment outcomes were assessed by clinical and radiological examination. Operation time, intraoperative blood loss and postoperative complications were documented.ResultsMean operative time was 222±78 minutes. Average blood loss was 993±361 mL. Anatomical reduction was achieved in all patients. Minimum follow-up period was 31 months. Postoperative hypoesthesia in the area of innervation of the lateral femoral cutaneous nerve was reported in one patient, with spontaneous recovery at one month after surgery. No complications were reported during the follow-up period. At the most recent follow up, clinical outcomes were graded as “excellent” in six patients, “good” in eight patients and “fair” in one patient based on the modified Merle d’Aubigné-Postel score.ConclusionsPSA appears to be a timesaving and safe approach for treatment of acetabular fractures that affords good visual access and allows for excellent fracture reduction. Our preliminary results revealed a much lower incidence of complications than traditional approaches, suggesting PSA is an alternative for treatment of acetabular fractures.

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Risk Factors of Surgical Site Infection after Acetabular Fracture Surgery

Cited by 35 publications

References 30 publications

Surgical Site Infection Following Fixation of Acetabular Fractures

Surgical Site Infection Following Fixation of Acetabular Fractures

Results of 167 consecutive cases of acetabular fractures using the Kocher-Langenbeck approach: a case series

A Novel Approach for Treatment of Acetabular Fractures

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