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

Abstract

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.

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

“…A systematic review and meta‐analysis revealed that 4.2% of patients who underwent foot and ankle surgery experienced SSI. 3 The findings from another systematic review and meta‐analysis revealed that the occurrence of SSI among patients following long bone surgery is 3.3%. 11 The variance in the prevalence of orthopaedic SSI between our study and these previous investigations can be attributed to the differences in surgical site locations.…”

“…In orthopaedic surgery, a surgical site infection (SSI) is characterized as an infection that develops within 30 days following surgery when no fixation devices have been implanted, or within 1 year if a metallic device remains implanted. 1 , 2 , 3 , 4 SSI represents a prevalent complication in both orthopaedic and various other surgical procedures. The elevated incidence of SSI can be attributed to factors such as the expanding range of orthopaedic indications, the intricate nature of orthopaedic surgeries and the frequent use of implants in these procedures.…”

“…Additionally, there is a substantial long‐term risk, with a 10%–20% lifetime likelihood of recurrence. 3 , 6 …”

Carbon Footprint of Minor Foot and Ankle Surgery: A Randomized Controlled Trial

“…An a priori sample size calculation regarding our secondary outcome, SSI rate, was performed using α = 0.05 and 80% power to detect a doubling of the expected 4% SSI rate reported in the literature for foot and ankle surgery. 4 This resulted in a sample size of 1106. Because the surgical site preparation remained the same for both protocols, the decision was made to base our sample size solely on our primary outcome.…”

Complications of cryoprobe cryoablation as a surgical adjuvant for the treatment of metastatic carcinoma to bone, benign bone tumors, and soft tissue tumors

“…2,3 Diabetes patients are prone to incision infection, and many literature reports that pancreatic-dependent and noninsulin pancreatic-dependent diabetes patients will increase the risk of incision infection. 4 Therefore, some studies have found that optimizing blood sugar levels can reduce the incidence of surgical incision infections. 5 Second, the surgical time is not given in Table 1.…”