scholarly journals Microbiology and Risk Factors of Surgical Site Infection in Limb Fractures

2020 ◽  
Author(s):  
Junchao Luo ◽  
Xinji Chen ◽  
Yu Tong ◽  
Yin Zhang ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Open Fractures ◽  
Site Infection ◽  
Chi Square ◽  
Orthopedic Surgeons ◽  
Lower Limb Fractures ◽  
Microbiological Characteristics ◽  
Zhejiang Provincial ◽  
Limb Fractures

Abstract Background: Limb fractures are becoming more common, and implant implants increase the risk of surgical site infection.The purpose of this study was to identify risk factors and microbiological characteristics for surgical site infection of limb fractures.Methods: We reviewed the data of 4,478 patients with limb fractures treated at Zhejiang Provincial People's Hospital from January 2010 to January 2020, including demographic, fracture, and microbiological characteristics. Chi-square tests and multivariate logistic regression were used to identify risk factors.Results: Staphylococcus aureus is a major threat to surgical site infection of limb fractures (26.46%). Open fractures are a risk factor for gram-negative infections. The following factors are considered as risk factors for surgical site infection: lower limb fractures, diabetes mellitus (OR 2.911 ; 95% CI 1.767-4.793), hypoproteinemia (OR 5.153 ; 95% CI 2.478-10.714), vascular injury(OR 8.531 ; 95% CI 4.028-18.070), nerve injury(OR 1.966 ; 95% CI 1.132-3.414) and open fractures (OR 9.561 ; 95% CI 6.565-13.925).Conclusions: Patients with these factors are at risk of surgical site infection after open reduction and internal fixation, and orthopedic surgeons should pay attention to these patients.

scholarly journals Liberal and Restrictive Blood Transfusion Strategies in Orthopedic Surgery: Risk Factors for Surgical Site Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s313-s314
Author(s):  
Hoberdan Pereira ◽  
Marcelo Perucci ◽  
Lucas de Lima ◽  
Daniel Bodour ◽  
Laura Vieira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Blood Transfusions ◽  
Site Infection ◽  
Lower Limb Fractures ◽  
Limb Fractures

Background: The identification of risk factors for infections in surgical patients with lower-limb fractures and blood transfusions has increased in recent years. Surgical site infections (SSIs) increase hospitalization, care costs, and patient suffering. Correction surgery for lower-limb fractures and blood transfusion is quite common between surgical procedures. The aim of this study was to describe the relationship between blood transfusion and SSI in patients undergoing orthopedic surgery on lower limbs. Methods: We conducted a prospective cohort study to identify risk factors for SSI in blood transfused patients undergoing fracture repair in lower-limb surgeries between February 2017 and May 2019 in 2 reference tertiary-care hospitals in Belo Horizonte, a city of 3 million people in Brazil. Data regarding patient characteristics, surgical procedures, blood transfusions, and surgical infections were collected. Patient characterization was performed by calculating the absolute and relative frequencies of categorical variables and calculating mean, median, minimum, maximum, standard deviation, and coefficient of variation for quantitative variables. The incidence of surgical site infection, the risk of postoperative hospital death, and the total length of hospital stay were calculated by point estimates and 95% confidence intervals identified by statistical tests of bilateral hypotheses, considering the level of significance of 5%. A multivariate analysis (logistic regression) was performed to identify SSI risk factors. Results: Patients who had an indication for blood transfusion (n = 38) but who did not receive blood (n = 4) had significantly lower hemoglobin, comparing discharge with admission, than the group who received blood. Intraoperative transfusion was a risk factor for SSI (OR, 4.7) (Fig. 1). Among the 205 patients with no indication for transfusion, 98 received blood even without the indication: there was no difference in hemoglobin outcome when discharge and admission were compared, and the 98 patients were exposed to unnecessary risk. Regarding restrictive versus liberal transfusion strategies, there were differences in the variables, age (P = .000), duration of surgery (P = .003), number of comorbidities (P = .000), body mass index (BMI) (P = .027), previous hemoglobin (P = .000), and high hemoglobin (P = .000), considering the transfusion practice employed (Fig. 2). Conclusions: The indications for and definition of protocols and careful evaluation of blood transfusion are critical to avoid infectious complications in orthopedic patients with lower-limb fractures.Funding: NoneDisclosures: None

scholarly journals Risk of surgical site infection in patients undergoing orthopedic surgery

2011 ◽  
Vol 19 (6) ◽  
pp. 1362-1368 ◽  
Author(s):  
Flávia Falci Ercole ◽  
Lúcia Maciel Castro Franco ◽  
Tamara Gonçalves Rezende Macieira ◽  
Luísa Cristina Crespo Wenceslau ◽  
Helena Isabel Nascimento de Resende ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Descriptive Analysis ◽  
Surgical Site Infections ◽  
Incidence Rates ◽  
Site Infection ◽  
Chi Square ◽  
Historical Cohort ◽  
Surgical Site Infection Incidence ◽  
Chi Square Test

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

scholarly journals Risk Factors For Traumatic Open Fracture in Children and Adolescents Presenting With Traumatic Fractures

2021 ◽  
Author(s):  
Hongwei Wang ◽  
Jun Liu ◽  
Deluo Wu ◽  
Lan Ou ◽  
Changqing Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Lower Limb ◽  
Open Fracture ◽  
Fracture Site ◽  
Open Fractures ◽  
Multiple Fractures ◽  
Lower Limb Fractures ◽  
Limb Fractures ◽  
Upper Limb Fractures

Abstract Background: To investigate the risk factors for open fractures in children and adolescents (≤18 years old) presenting with traumatic fractures.Methods: We retrospectively reviewed the records of 2418 children and adolescents who presented with traumatic fractures and were admitted to our university-affiliated hospitals, among which 206 patients (8.5%) presented with open fractures.Results: This study enrolled 1789 males (74.0%) and 629 females (26.0%) with an average age of 11.2±5.0 years. There were 206 patients (8.5%) who presented with open fractures. The five most common fracture sites were the tibia (31.1%, 64/206), fibula (20.9%, 43/206), phalanx (15.5%, 32/206), humerus (11.2%, 23/206) and ulna (9.7%, 20/206). Univariate logistic regression analysis showed that the aetiology (P﹤0.001) and fracture site (P﹤0.001) were risk factors for open fracture. Multivariate logistic regression analysis indicated that mechanical trauma (OR=64.229, P﹤0.001), being hurt/cut by others (OR=26.757, P﹤0.001), and being struck by an object (OR=15.345, P﹤0.001) were stronger risk factors for open fracture than were low falls; additionally, lower limb fractures (OR=5.970, P﹤0.001), upper limb fractures (OR=5.865, P﹤0.001) and multiple fractures (OR=5.414, P﹤0.001) were stronger risk factors than craniofacial fractures for open fractures.Conclusions: Aetiology (especially being injured by a machine or being hurt/cut by others) and the fracture site (including lower limb fractures, upper limb fractures and multiple fractures) were independent risk factors for open fractures.

scholarly journals Surgical site infection among gynecological group: risk factors and postoperative effect

2018 ◽  
Vol 7 (3) ◽  
pp. 966 ◽  
Author(s):  
Sunanda Bharatnur ◽  
Vandana Agarwal
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Substantial Reduction ◽  
Postoperative Recovery ◽  
P Value ◽  
Site Infection ◽  
Continuous Variables ◽  
Chi Square ◽  
Mattress Suture ◽  
Clean Contaminated

Background: This study was carried out to evaluate the preoperative and intraoperative risk factors associated with surgical site infection amongst gynecology patients and its impact on postoperative recovery.Methods: A prospective, observational study was conducted among 285 patientsWho underwent surgery over a period of two years. Diagnosis of SSI was made as per CDC criteria. Various risk factors and impact of SSI on postoperative recovery were analysed. Statistical analysis was carried out with SPSS version 16.0. Range and mean was calculated for continuous variables and overall incidence rate of SSI is also calculated. Pearson Chi-square test was used to test risk factor association with SSI. Odds ratios and 95% confidence intervals (CI) was calculated. Significance was assumed at a p value of less than 0.05.Results: The incidence of SSI was found to be 52 out of 285 women (46%). Majority of SSI, i.e. 49 out of 52 (94%) were superficial in nature. Deep SSI was seen in 3 patients (6%). No organ/space infection was noted in any patient. Women who were over 50 years had higher risk of developing SSI than women between 36 to 50 years (OR 0.519 Vs 0.214). The risk of SSI was 4 times in case of clean contaminated wounds as compared to clean wounds (OR 3.877). The risk further increased to 7 times in case of dirty wounds (OR 6.753). Other risk factors which are significantly associated with SSI were BMI (p value <0.001), midline incisions (p <0.001) and Mattress suture (p <0.001). Presence of previous scar had intraoperative adhesions, weaker scar and poor healing which predispose to development of SSI. Comorbidities which influence SSI’s in the present study are diabetes mellitus (OR 5.49, 95% CI 2.506-12.066, P <0.001), anaemia (OR 4.63, Cl 2.458-8.756) and hypertension (OR 2.46, Cl 0.994-6.117). Wound swab was sterile in 33(63%) cases and 18(35%) cases showed growth of the organism. Most common organism noted was E. coli 9 (50%) followed by Klebsiella and Staph aureus.Conclusions: SSIs are increasing in the current scenario due to increase in the number of surgeries, however they can be prevented by early identification and optimization of medical comorbidities and BMI. Meticulous preoperative workup and intraoperative surgical steps are important in reducing the risk of developing SSI.  A decrease in infection rate can lead to substantial reduction in the burden of disease.

Microbiology Characteristics and Risk Factors of Surgical Site Infection in Limb Fractures: a Single-center Retrospective Study

2021 ◽  
Author(s):  
Junchao Luo ◽  
Xinji Chen ◽  
Yin Zhang ◽  
Yu Tong ◽  
Senbo Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Internal Fixation ◽  
Surgical Site Infections ◽  
High Energy ◽  
Fracture Site ◽  
Coagulase Negative Staphylococcus ◽  
Site Infection ◽  
Preventative Measures ◽  
Limb Fractures

Abstract Background: Limb fractures were becoming more common, and internal fixation increased the risk of surgical site infection. The purpose of this study was to identified risk factors for surgical site infection and the factors that affected the microbiological characteristics.Material and methods: Data from patients with limb fractures who received internal fixation between January 2010 and January 2020 were included. Univariate and multivariate logistic analyses were performed to determine independent risk factors.Results: A total of 4479 patients were identified and 187 (4.18%) patients developed surgical site infections (SSI). Staphylococcus aureus (25.1%) was the most common bacteria, followed by Coagulase negative Staphylococcus (18.8%) and Acinetobacter baumannii (12.0%). Multiple regression analysis revealed that low total protein (OR, 4.066; 95% CI, 1.217-13.583) and high white blood cell count (OR, 3.133; 95% CI, 1.291-7.605) were risk factors for gram-negative bacteria infection. Five risk factors were identified to be independently associated with the development of SSIs, including current smoking (OR, 2.923; 95% CI, 1.294-6.599), high-energy injury (OR, 2.816; 95% CI, 1.368-5.799), femoral fracture, tibia and fibula fracture, vascular injury at the fracture site (OR, 10.284; 95% CI, 2.506-42.199), skin contusin at the fracture site (OR, 3.348; 95% CI, 1.304-8.574), hypohemoglobin (OR, 2.991; 95% CI, 1.422-6.292).Conclusion: Preoperative preventative measures should be taken in patients at high risk to reduce the incidence of SSIs.

Study on surgical site infection following laryngectomy and its risk factors

2011 ◽  
Vol 31 (5) ◽  
pp. 521-523
Author(s):  
Qian XIE ◽  
Bin CAO ◽  
Yong-xiang WEI ◽  
Ning-yu WANG ◽  
Jin-feng LIU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Site Infection

scholarly journals Incidence of surgical site infection in dogs undergoing soft tissue surgery: risk factors and economic impact

2019 ◽  
Vol 6 (1) ◽  
pp. e000233
Author(s):  
Jorge Espinel-Rupérez ◽  
Maria Dolores Martín-Ríos ◽  
Veronica Salazar ◽  
Maria Rosario Baquero-Artigao ◽  
Gustavo Ortiz-Díez
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Surgical Site Infection ◽  
Economic Impact ◽  
Teaching Hospital ◽  
Primary Outcome Measure ◽  
Site Infection ◽  
Urinary Catheterisation ◽  
Organ Space Infection ◽  
Soft Tissue Surgery

ObjectivesTo determine (1) the incidence of surgical site infection (SSI) in patients undergoing soft tissue surgery at a veterinary teaching hospital and to study (2) and describe the main risk factors associated with SSI and (3) assess the economic impact of SSI.DesignProspective cohort study.SettingVeterinary teaching hospital.Participants184 dogs undergoing soft tissue surgery during a 12-month period (October 2013 to September 2014).Primary outcome measureSurgical site infection.ResultsOut of the 184 patients analysed, SSI was diagnosed in 16 (8.7 per cent) patients, 13 (81.3 per cent) were classified as superficial incisional infection, 2 (12.5 per cent) as deep incisional infection and 1 (6.3 per cent) as organ/space infection. The administration of steroidal anti-inflammatory drugs (P=0.028), preoperative hyperglycaemia (P=0.015), surgical times longer than 60 minutes (P=0.013), urinary catheterisation (P=0.037) and wrong use of the Elizabethan collar (P=0.025) were identified as risk factors. Total costs increased 74.4 per cent, with an increase in postsurgical costs of 142.2 per cent.ConclusionsThe incidence of SSI was higher than the incidence reported in other published studies, although they were within expected ranges when a surveillance system was implemented. This incidence correlated with an increase in costs. Additionally new important risk factors for its development were detected.

Risk Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery

JBJS Reviews ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e0163
Author(s):  
Hiroko Matsumoto ◽  
Matthew E. Simhon ◽  
Megan L. Campbell ◽  
Michael G. Vitale ◽  
Elaine L. Larson
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
Site Infection ◽  
Factors Associated ◽  
Spinal Deformity Surgery
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