Early postoperative wound infections in hemiarthroplasties in South-South, Nigeria: A multicenter-based study

Abstract

Background: The most common treatment for displaced femoral neck fractures in the elderly patient is hemiarthroplasty. Postoperative wound infection is considered early when it occurs within 30 days of orthopedic operations. Infection rates vary in the literature. Availability of descriptive data is limited. Patients and Methods: Medical records of 40 out of 52 patients who had hemiarthroplasties in Irrua Specialist Teaching Hospital, Irrua, Edo State and Delta State University Teaching Hospital Oghara, 2007–2016 were reviewed retrospectively. All patients had prophylactic as well as presumptive antibiotic treatment. All had ceftriaxone and metronidazole at one point or the other. Results: Of the 40 patients, age range was 17–91 years; median age was 65 years with a slight female to male preponderance. Twenty-two (55%) patients were 60–90 years of age. Trivial/domestic falls accounted for the majority, 26 (65%) patients. Only 3 (7.5%) patients presented within 24 h. Hypertension (HT) was the most common comorbid medical condition, 67.5%. Wound infection was the most common complication noted 7 (17.5%). Polymicrobial (mixed) infection agents ranked the highest among the microbes' cultures. Five out of the seven patients with wound infection had superficial wound infection. Two had deep wound infections. Ceftriaxone and metronidazole were the most commonly used antibiotics and the most effective against infections. Genticin was uncommon. Conclusion: Sixty-seven percent of patients studied had wound infection. Superficial wound infections were the most predominant type of early postoperative wound infection, and polymicrobial mixed infection agents were the most implicated. HT was the most common comorbid medical condition identified.