Predictive model for surgical site infection risk after surgery for high-energy lower-extremity fractures

Abstract

Prognostic study, level II.

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

“…We considered an ORIF patient to have a high risk of developing SSI if he or she had severe systemic disease affecting his or her general health and immunity, extensive skin or tissue injuries with dirty and contaminated wounds at the incision sites, multiple implants, or long duration of surgeries. Other risk factors, such as the patient's age (>65 years) and body mass index (>40 kg/ m 2 ), may also affect the SSI rate [1,10,18,25,29]. However, to make the scorecard simple and practical, we did not include all possible risk factors.…”

“…The recognised SSI risk factors include patients' general health and certain comorbidities, such as diabetes and peripheral vascular disease [15,22,25,27,34]. The type of fractures (low vs. high energy), number of implants, duration of surgery, and surgical site/wound condition (open vs. closed fracture) are also independent and significant risk factors that predispose patients to SSI [17,23,27,33].…”

“…We designed a SSI risk factor scorecard (Table 1) by considering five major SSI risk factors associated with ORIF surgeries according to related literature about SSI in surgical patients [15,22,24,25,31,33,34]. Each risk factor was assessed as low (1 point), medium (2 points), or high (5 points).…”

Confección de un modelo predictor para infección de herida operatoria en pacientes adultos intervenidos de artroplastía total de cadera en un hospital de alta complejidad, años 2012 y 2014

“…Al observar el modelo predictivo obtenido, resalta que incluye variables que según la revisión de la literatura www.revinf.cl mente descrita, por lo que quizás en algunos pacientes no se pudo obtener de forma correcta, dado que durante el intraoperatorio los registros de sangramiento son escasos y en el post-operatorio no se pudo determinar el valor del hematocrito en algunos pacientes, por no encontrarse dicha detección en los registros clínicos analizados. Es probable que la administración de glóbulos rojos en la cohorte estudiada se muestre como un "proxy" del sangramiento intraoperatorio y posterior anemia, dado que es dudoso que solo el hecho de recibir una transfusión genere algún mecanismo que pudiera aumentar el riesgo de una IHO, dado que el proceso de la preparación y administración especializada, se presentan como factores asociados para una IHO en pacientes intervenidos de ATC 2,4,10, [16][17][18]20,22,[26][27][28][29][30] . Respecto a incumplimiento en la antibioprofilaxis, concuerda con la literatura revisada que se presenta como un factor de riesgo 12,23,27,31 , pero en el presente estudio, solamente resulta significativo el incumplimiento del tiempo de administración, y no otros factores como el ajuste por peso o el refuerzo ante una cirugía prolongada o sangramiento excesivo.…”

Posttraumatic orthopaedic wound infections

“…However, in a level II prognostic study, Paryavi et al 18 concluded that the use of the National Nosocomial Infections Surveillance (NNIS) system and the Study on the Efficacy of Nosocomial Infection Control (SENIC) scores are not predictive of SSI after orthopaedic trauma surgery. ROC curves indicated the NNIS score was 0.52 (95% confidence interval [CI], 0.45-0.59), the SENIC score was 0.49 (95% CI, 0.41-0.58) and the NNIS and SENIC scores combined, 0.50 (95% CI, 0.41-0.59).…”