Postoperative surgical site infection following acetabular fracture fixation

Acetabular fractures labelled poor surgical choices: Analysis of operative outcome

“…4,23, 24 Suzuki et al found that higher Injury Severity Score, longer intensive care unit (ICU) stays, larger amount of packed red blood cells transfused, longer operative time, larger estimated operative blood loss, higher body mass index (BMI), more frequent performance of combined approach, association of urinary tract injury, and Morel-Lavallee lesion predisposed to development of infection after surgical management of acetabular fractures. 25 The results published from developing countries earlier also report a similar incidence of infection suggesting that the factors leading to increased infection in our series might be attributable to causes like poor hygiene, poor infrastructure and operating room conditions as compared to the western world. 9 The inferences that can be drawn from the present study show that the complication rates in the acetabular injuries otherwise labelled as poor surgical choices are marginally higher as compared to the world literature for fractures which are recommended to be routinely operated.…”

Evaluating the use of antibiotic prophylaxis during open reduction and internal fixation surgery in patients at low risk of surgical site infection

“…However, to make the scorecard simple and practical, we did not include all possible risk factors. The reported overall SSI rate associated with ORIF surgeries ranges from 5.2% to 16% [19,21,30,32]. Using our scoring method, about one third of our patients receiving ORIF procedures were identified as having a low SSI risk.…”

“…Also, there is no strong evidence regarding whether prophylactic antibiotics can reduce the occurrence of SSI in orthopaedic patients at low risk of developing infection. Although our understanding of SSI remains incomplete, various types of risk factors, such as the patient's general health status and the degree of trauma and fractures, can contribute to the development of SSI in orthopaedic patients [18,22,24,32,34]. We reasoned that the major risk factors that predispose a person to SSI could be assessed and graded for patients receiving ORIF surgeries.…”

Fix and replace; an emerging paradigm for treating acetabular fractures

“…For those treated with ORIF, the standard post operative complications in elderly patients are de rigueur, in addition to the late local complications, including HO, sciatic nerve palsy, prominence of metalwork or failure of fixation and infection. Risk factors for surgical site infection include high BMI, presence of MorelLavallée lesions and stay in the intensive care (46). Given the paucity of studies comparing directly the outcomes between acute THR for acetabular fractures and those treated with ORIF in the elderly cohort, further randomised control trials are needed to determine optimal therapy in this extremely challenging cohort of patients, in addition to delineating the effects of comorbidities, as- Figure 1 -AP pelvis of a 73-year-old man (fall from standing height, symptomatic left osteoarthritis before fall), presenting with a left acetabular fracture.…”