English

Abstract

Postoperative SSI in orthopaedic procedures involving implants is one of the most costly complications. Studies estimated that SSIs prolong total hospital stays by a median of two weeks per patient. Moreover, orthopaedic patients with SSIs have substantially greater physical limitations and significant reductions in their quality of life. Aim was to establish infection control policy and assess the incidence of SSIs in DHS and also validate the infection control policy of our hospital by comparing rates with already published reports. The study was conducted at a multi- specialty tertiary care centre. 70 patients with intertrochanteric fracture undergoing DHS surgery during the period of Jan-2011 to Dec-2011 with an NHSN risk index of 0 were enrolled into the study. A minimum follow up was for 1 year. Of the 70 surgeries, 1(1.4%) Superficial incisional SSI was noticed and it settled down with debridement and antibiotics. No deep or organ space infection was noted. Our result was favorably comparable with the NHSN data between 2006-2008 showed 0.67-2.4 per 100 operations and also other similar published reports. CONCLUSION: BUGS ARE AHEAD OF HUMANS. We have to evolve ourselves beyond drug therapy to fight SSI. Prevention of SSIs is based on structured protocols, which are evolved by the hospital infection control committee. The policy has to be specific to the hospital based on broad guideline already published. A more holistic approach with a dedicated team to monitor the infection control protocols and the infection rates along with antibiotic policy is order of the day. There is a scope for improvement as ever and the goal is to reduce the SSI incidence to near 0%. Based on our findings we can with confidence say that we can reduce the incidence of SSIs to near 0% with a good protocol of infection control policy. INTRODUCTION: Postoperative SSI (Surgical Site infection) in orthopaedic procedures involving implants is one of the most costly complications. This is due to hospital readmissions, extended length of stay at the hospital, the need for additional procedures( removal and re implantation of implanted hardware), convalescent or nursing home care between procedure, and significant increases in direct hospital cost(eg, prolonged antimicrobial therapy). It also affects the patient's social and economic status 1&2 . One study estimated that orthopaedic SSIs prolong total hospital stays by a median of two weeks per patient, approximately double readmission rates, and increase healthcare costs by more than 300%. Moreover, patients with orthopaedic SSIs have substantially greater physical limitations and significant reductions in their quality of life. 1 In light of the serious consequences, antimicrobial prophylaxis is well accepted in procedures involving the implantation of foreign materials. 3, 4