Abstract
BackgroundThere remain limited data on the epidemiological characteristics and related predictors of surgical site infection (SSI) after open reduction and internal fixation (ORIF) for distal femur fractures (DFFs). We designed this single-centre prospective study to explore and forecast these clinical problems.MethodsFrom October 2014 to December 2018, 364 patients with DFFs were treated with ORIF and followed for complete data within one year. Receiver operating characteristic (ROC) analyses, univariate Chi-square analyses, and multiple logistic regression analyses were used to screen the adjusted predictors of SSI.ResultsThe incidence of SSI was 6.0 % (22/364): 2.4 % (9/364) for superficial SSIs and 3.6 % (13/364) for deep SSIs. Staphylococcus aureus (methicillin-resistant S. aureus in 2 cases) was the most common pathogenic bacteria (36.8 %,7/19). In multivariate analysis, parameters independently associated with SSI were: Open fracture (OR: 7.3, p = 0.003), drain use (OR: 4.1, p = 0.037), and incision cleanliness (OR: 3.5, p = 0.002). An albumin/globulin (A/G) level ≥ 1.35 (OR: 0.2, p = 0.042) was an adjusted protective factor for SSI.ConclusionsThe SSI after ORIF affected approximately one in 15 patients with DFFs. The open fracture, drain use, high grade of intraoperative incision cleanliness, and preoperative A/G levels lower than 1.35 were significantly related to increasing the risk of post-operative SSI after DFFs. We recommended that more attentions should be paid to these risk factors during hospitalization.Trial registrationNO 2014-015-1, October /15/2014, prospectively registered.We registered our trial prospectively in October 15, 2014 before the first participant was enrolled. This study protocol was conducted according to the Declaration of Helsinki and approved by the Institutional Review Board. The ethics committee approved the Surgical Site Infection in Orthopaedic Surgery (NO 2014-015-1). Data used in this study were obtained from the patients who underwent orthopaedic surgeries between October 2014 to December 2018.
Highlights
There remain limited data on the epidemiological characteristics and related predictors of surgical site infection (SSI) after open reduction and internal fixation (ORIF) for distal femur fractures (DFFs)
Study design A prospective study was designed, and data were collected from patients who underwent ORIF for DFFs from October 2014 to December 2018
A total of 461 patients with DFFs were admitted for ORIF, and 47 patients were less than years old; suffered from pathological fractures; 5 had old fractures; 2 had incomplete data, and 24 were lost (6.2 %) to follow-up. 364 patients were included for the final analysis
Summary
There remain limited data on the epidemiological characteristics and related predictors of surgical site infection (SSI) after open reduction and internal fixation (ORIF) for distal femur fractures (DFFs). We designed this single-centre prospective study to explore and forecast these clinical problems. Distal femur fractures (DFFs) are relatively uncommon but severe in orthopaedic trauma, comprising approximately 8.7 % of all femoral fractures and 0.8 % of total body fractures in Chinese adults [1]. Excessive soft tissue dissection during operation may impair the already damaged soft tissue, possibly leading to postoperative complications such as surgical incision site, knee dysfunction and bone union [5, 6]
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