A prospective study of surgical site infection of orthopedic implant surgeries

Abstract

<p class="abstract"><strong>Background:</strong> Surgical-site infection accounts for approximately 10% of all hospital-acquired infections, which are estimated to double the cost of care and result in an additional mean of 6.5 days of hospital stay. We did prospective study of surgical site infection of orthopaedic implant surgeries.</p><p class="abstract"><strong>Methods:</strong> The aim of the study is to assess the clinical and microbiological outcome of 125 patients who had open reduction and internal fixation with implants and prosthesis at Southern Railway Hospital from January 2006 to January 2007, and its strength of association with major risk factors using univariate analysis. In our study, Patients were allocated in to three groups as NINS risk index group 0, 1 and 2 with risk factors as duration of surgery >2 hours and ASA class ≥3. Post-operative wound infection was diagnosed based on the criteria of Center of Disease Control and assessed for the period of 6 weeks using National Nosocomial Infections Surveillance Risk Index.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 87 male and 38 females in the study. From 125 Patients, 13 patients had post-operative superficial surgical site infection and presented within 21 days of operation. The infection rate was 10.4%. Two Patients developed deep infection after 6 weeks of study. All the cases with superficial infection were followed at regular intervals, 11 cases resolved with regular dressing and antibiotics but 2 cases continued to discharge sinus up to 3 months.</p><p><strong>Conclusions:</strong> The study showed that the risk of infection rate increased significantly with ASA score, duration of surgery, obesity and NINS risk index. There was no significant association of infection rate with age, diabetes and smoking. </p>

Surgical site infections after orthopedic procedures in a tertiary hospital in Oman: Incidence, characteristics and risk factors

“…In comparison, apart from the study conducted in Belgrade [18] with incidence of 22.7%, incidence in developing countries ranged between 2.55% and 11.0% depending on the type of orthopedic surgery, emergency versus elective procedures and patient risk factors [5] This study showed that the incidence in our setting (8.57%) is toward the higher end which indicates the need for prompt action to handle this issue. The striking result in this study is the high incidence of SSIs among arthroplasties (11.70%) giving the fact that most of these were elective procedures done on clean site.…”

“…reported SSIs significantly associated with ASA of >2 [5][18].The majority of SSI episodes (89.03%) occurred in the first 6 months following the procedures with 58.54% in the first 30 days similar to what has been reported earlier[6][9]. The majority were superficial SSI as was reported in several studies[5][20].The significantly higher incidence of SSI among ORIF procedures done on open fractures than on closed fractures is expected with open fractures are more likely to be contaminated with pathogens at time of presentation. This has been shown in several studies with some considering open fracture as a risk factor for developing SSI[27][28]…”

Prophylactic surgical drainage is associated with increased infection following intramedullary nailing of diaphyseal long bone fractures: A prospective cohort study in Nigeria

“…Interestingly, females demonstrated a strong association with increased risk of SSI compared to males. Some previous Nigerian literature has demonstrated a trend towards increased infections in females following surgical procedures of any type [18,[21][22][23]. Conversely, other Nigerian studies have demonstrated no significant difference between sexes in risk of SSI following orthopaedic procedures [24][25][26].…”

Incidence of surgical site infections and associated risk factors in clean orthopaedic surgeries

“…Infections after orthopedic surgical procedures are devastating complications which have significant clinical and financial 3 . Studies have documented SSI in orthopaedic setting ranging from 0.3% to 25% [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] , with incidence approximately 4 times higher in low-and middle-income countries than in high income countries 1 .…”

“…In India, studies have shown SSI rates ranging between 4% and 70% in different types of orthopedic wound (clean/ contaminated/infected) surgeries with association of several independent risk factors [14][15][16][17][18][19] . However, there is a paucity of data on SSI especially in clean orthopaedic surgical procedures in India.…”