Comparison study of patient demographics and risk factors for surgical site infections following open reduction and internal fixation for lateral malleolar ankle fractures within the medicare population

Richardson, Nicholas G.; Swiggett, Samuel J.; Pasternack, Jordan B.; Vakharia, Rushabh M.; Kang, Kevin; Abdelgawad, Amr

doi:10.1016/j.fas.2020.11.008

Cited by 12 publications

(14 citation statements)

References 34 publications

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“…As shown in Figure 2, all included studies 18,26–33 were of high quality. Also, one study 27 did not report funding sources or conflicts of interest.…”

Section: Resultsmentioning

confidence: 99%

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

Zaboli Mahdiabadi,

Farhadi,

Shahroudi

et al. 2024

International Wound Journal

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The present systematic review and meta‐analysis aimed to determine the prevalence of surgical site infection (SSI) and risk factors in patients after knee surgery. A comprehensive and systematic search was carried out across various international electronic databases, including Scopus, PubMed and Web of Science, as well as Persian electronic databases like Iranmedex and the Scientific Information Database (SID). This search involved the utilization of keywords derived from Medical Subject Headings, such as ‘Prevalence’, ‘Surgical wound infection’, ‘Surgical site infection’ and ‘Orthopaedics’, spanning from the earliest records up to 1 October 2023. To assess the quality of the included studies, the Appraisal tool for Cross‐Sectional Studies (AXIS tool) was utilized. The study encompassed a combined participant pool of 11 028 individuals who underwent knee surgery across seven selected studies. The collective prevalence of SSI in patients who underwent knee surgery, as reported in the seven included studies, was determined to be 3.0% (95% CI: 1.2% to 7.5%; I2 = 96.612%; p < 0.001). The combined prevalence of SSI in patients with DM, as reported in six studies, was 5.1% (95% CI: 1.7% to 14.5%; I2 = 79.054%; p < 0.001). Similarly, the pooled prevalence of SSI in patients with HTN, drawn from four studies, was 1.8% (95% CI: 0.7% to 4.5%; I2 = 63.996%; p = 0.040). Additionally, the collective prevalence of SSI in patients with a history of tobacco use, based on findings from six studies, was 4.8% (95% CI: 1.4% to 15.2%; I2 = 93.358%; p < 0.001). Subgroup analysis was conducted within six studies, categorizing them by two countries, namely China and the USA. These analyses revealed that the prevalence of SSI following knee surgery was 3.0% in China and 2.0% in the USA. It is noteworthy that variations in SSI prevalence across different studies may be attributed to a multitude of factors, particularly varying risk factors among patient populations. To address this issue and mitigate the impact of SSI on knee surgery patients, it is advisable to develop tailored interventions.

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“…As shown in Figure 2, all included studies 18,26–33 were of high quality. Also, one study 27 did not report funding sources or conflicts of interest.…”

Section: Resultsmentioning

confidence: 99%

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

Zaboli Mahdiabadi,

Farhadi,

Shahroudi

et al. 2024

International Wound Journal

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“…As shown in Figure 2, all included studies 6,11,15–21 were of high quality. Also, one study 6 did not report funding sources or conflicts of interest.…”

Section: Resultsmentioning

confidence: 99%

“…After carefully reading the full text of 45 studies, 19 studies were eliminated due to poor research design or results, and 17 studies were eliminated due to a lack of relevant data. Finally, nine studies 6 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 were considered in this systematic review and meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

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

Cheng,

Zhang,

Zhang

et al. 2023

International Wound Journal

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The present systematic review and meta‐analysis aimed to determine the prevalence of surgical site infection (SSI) and related factors in patients after foot and ankle 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 (SID) using keywords extracted from Medical Subject Headings such as ‘Prevalence’, ‘Surgical wound infection’, ‘Surgical site infection’ and ‘Orthopaedics’ from the earliest to 1 June 2023. The appraisal tool for cross‐sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 10 447 patients undergoing foot and ankle surgery participated in nine studies. The pooled prevalence of SSI in patients who underwent foot and ankle surgery was reported in nine studies was 4.2% (95% CI: 2.4%–7.2%; I2 = 96.793%; p < 0.001). The odds ratio of SSI prevalence in men was higher than that of women and was significant (OR: 1.335; 95% CI: 1.106–1.612; Z = 3.009; p = 0.003). The pooled prevalence of SSI in patients with hindfoot fracture sites reported in five studies was 4.9% (95% CI: 2.6%–8.9%; I2 = 90.768%; p < 0.001). The pooled prevalence of SSI in patients with diabetes mellitus (DM) reported in six studies was 9.1% (95% CI: 5.6%–14.6%; I2 = 73.957%; p = 0.002). The pooled prevalence of SSI in patients with hypertension (HTN) reported in five studies was 5.5% (95% CI: 2.5%–11.6%; I2 = 91.346%; p < 0.001). The pooled prevalence of SSI in patients with tobacco use reported in eight studies was 6.6% (95% CI: 4.1%–10.4%; I2 = 85.379%; p < 0.001). In general, the existing differences in the prevalence of SSI after foot and ankle surgery in different studies can be based on different risk factors such as comorbidities and gender. Therefore, it is suggested to design appropriate interventions to reduce SSI in these patients.

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“…Most studies in the literature examine the incidence of AEs after surgical treatment of supination-external rotation type fractures. However, these also include bi- or trimalleolar fractures which makes it difficult to assess the relationship between specific subcategories of ankle injuries and the rate of AEs [ 30 ]. Only limited data are available on the specific incidence of AEs after surgical treatment of ILMFs.…”

Section: Discussionmentioning

confidence: 99%

“…The analysis showed that in the surgical group ( n = 72), 5 patients (7%) required further unplanned surgery, 2 (3%) had major infection, 11 had (15%) minor infection, 5 (7%) had neurological injury, and 5 patients had (7%) deep vein thrombosis. In a retrospective study by Richardson et al 10.7% of patients treated with ORIF following a lateral malleolar fracture developed surgical site infection within one year after surgery [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study

et al. 2022

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Background Recent systematic reviews support that non-operative management should be the standard treatment for all stable isolated lateral malleolar fractures (ILMFs), regardless of fibular fracture displacement. Surgical fixation of ILMFs carries a risk of adverse events (AEs), and many patients will later require implant removal. We wanted to estimate the incidence of AEs requiring revision after surgical fixation of “potentially stable” displaced ILMFs before non-operative treatment became standard care in our department. Materials and methods To identify patients with “potentially stable” ILMFs who had been treated surgically in a historical cohort, we retrospectively applied the stability-based classification system, introduced by Michelson et al., to a cohort of 1006 patients with ankle fractures treated surgically from 2011 to 2016. The primary outcome of this retrospective cohort study was the incidence of AEs that had functionally significant adverse effects on outcome and required revision in the first 12 months after surgery. AEs were graded and categorized using the Orthopedic Surgical Adverse Events Severity (OrthoSAVES) System. Results The study population comprised 108 patients with “potentially stable” displaced ILMFs; 4 patients (3.7% [95% CI (0.1–7.3%]) experienced AEs requiring revision in the first twelve months after surgery. There were 5 additional patients (4.6%) with functionally significant AEs where revision surgery was not indicated within the first twelve months after surgical fixation. A further 5 patients (4.6%) had AEs managed in the outpatient clinic (grade II); 36 patients (33.3%) required secondary implant removal due to implant-related discomfort. Conclusions Surgical fixation of ILMFs carries a risk of severe AEs, and many patients will subsequently need implant-removal procedures. Further prospective studies are required to ascertain whether non-operative treatment can lower the risk of AEs and the need for additional surgical procedures.

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Comparison study of patient demographics and risk factors for surgical site infections following open reduction and internal fixation for lateral malleolar ankle fractures within the medicare population

Cited by 12 publications

References 34 publications

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

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

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

Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study

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