Incidence and risk factors for surgical site infection following volar locking plating (VLP) of unstable distal radius fracture (DRF)

Abstract

Purpose Volar locking plating (VLP) is the mainstay of treatment for distal radius fracture (DRF) but may be compromised by postoperative surgical site infection (SSI). This study aimed to identify the incidence and the risk factors for SSI following VLP of DRF. Methods This retrospective study identified consecutive patients who underwent VLP for closed unstable DRFs in our institution between January 2015 and June 2021. Postoperative SSI was identified by inquiring the medical records, the follow-up records or the readmission medical records for treatment of SSI. The potential factors for SSI were extracted from the medical records. Univariate and multivariate logistic regression analyses were performed to identify the independent factors. Results There were 930 patients included, and 34 had an SSI, representing an incidence of 3.7% (95% CI 2.4–4.9%). Patients with an SSI had threefold extended hospitalization stay (44.1 ± 38.2 versus 14.4 ± 12.5 days) as did those without. In univariate analysis, 18 variables were tested to be statistically different between SSI and non-SSI group. In multivariate analysis, 6 factors were identified as independently associated with SSI, including sex (male vs. female, OR 3.5, p = 0.014), ASA (III and IV vs. I, OR 3.2, p = 0.031), smoking (yes vs. no, OR 2.4, p = 0.015), bone grafting (OR 4.0, p = 0.007), surgeon volume (low vs. high, OR 2.7, p 0.011) and operation at night-time (vs. day-time, OR 7.8, p < 0.001). Conclusion The postoperative SSI of VLP of DRF was not uncommon, and the factors identified in this study, especially those modifiable, would help identify individual SSI risk, target clinical surveillance and inform patient counseling.

Surgical site infection following open lobectomy in patients with lung cancer: A prospective study

“…The interpretation of the higher (nearly twofolds) SSI rate we observed in the ASA score 3/4 group was not shown in another study in patients resected to lung neoplasm 25 . However, several studies had confirmed that the ASA score 3/4 was an independent risk factor for SSI in general surgeries 26–28 …”

“…25 However, several studies had confirmed that the ASA score 3/4 was an independent risk factor for SSI in general surgeries. [26][27][28] Several studies 20,[22][23] had shown that prolonged operating time was an independent risk factor for SSI. This was consistent with our study.…”

The impact of smoking on hospital course and postoperative outcomes in patients with fracture-related infections

“…1,2 FRIs occur in approximately 1%-4% of all operative fracture repairs, with a reported incidence as high as 30% for open fractures. [3][4][5] Bacterial seeding of fracturerelated wounds can arise from numerous sources including penetrating trauma, iatrogenic sources, or hematogenous spread. 6 Staphylococci are the most common bacterial genus involved in FRIs, and Staphylococcus aureus is capable of forming biofilms that enable growth on the surface of bone and implants, which can complicate disease eradication.…”