The Effect of Operative Time on Surgical Site Infection Following Total Shoulder Arthroplasty.

Abstract

Many factors contribute to the risk of surgical site infection (SSI) following total shoulder arthroplasty (TSA). Operative time is a modifiable factor that may contribute to SSI occurrence following TSA. This study aims to determine the correlation between operative time and SSI following TSA. Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, a total of 33,987 patient records were queried from 2006 to 2020 and sorted by operative time and the development of an SSI in the 30-day postoperative period. Odds ratio's for developing an SSI were calculated based on operative time. Of the 33,470 patients in this study, 169 patients developed an SSI in the 30-day postoperative period resulting in an overall SSI rate of 0.50%. A positive correlation was identified between operative time and the rate of SSI. An inflection point was identified at 180 minutes of operative time, with a significant increase in the rate of SSI occurrences for operative times over 180 minutes. Increased operative time was shown to be strongly correlated with an increased risk of SSI within 30 days following surgery, with a significant inflection point at 180 minutes. Target operative time for TSA should be under 180 minutes to reduce the risk of SSI.