Study of incidence of postoperative wound infection in orthopaedic surgery: A retrospective observational study.
DOI:
https://doi.org/10.51168/qbenyz45Keywords:
postoperative wound infection, surgical site infection, orthopaedic surgery, incidence, risk factors, retrospective study, infection controlAbstract
Background
Postoperative wound infection, or surgical site infection (SSI), is an important complication following orthopaedic surgery and may result in delayed wound healing, prolonged hospitalization, and additional treatment. This study evaluated the incidence of postoperative wound infection and associated demographic, clinical, and surgical factors.
Objective
To determine the incidence of postoperative wound infection among patients undergoing orthopaedic surgery and evaluate associated risk factors.
Materials and Methods
A retrospective observational study was conducted in the Department of Orthopaedics, Katihar Medical College, Katihar, Bihar, India. Hospital records of patients who underwent orthopaedic surgery between February 2024 and February 2025 were reviewed. A total of 100 eligible patients with complete perioperative records were included. Demographic characteristics, comorbidities, surgical characteristics, wound classification, implant use, microbiological findings, treatment, and clinical outcomes were evaluated.
Results
Postoperative wound infection occurred in 12 of 100 patients, giving an overall incidence of 12.0%. Infection was more frequent among patients with diabetes mellitus, prolonged operative duration, open fractures, implant-related procedures, and contaminated wounds. Staphylococcus aureus was the most commonly isolated microorganism. Most infections were successfully managed with culture-directed antibiotic therapy, while a smaller proportion required surgical wound debridement.
Conclusion
Postoperative wound infection remains an important complication following orthopaedic surgery, with an incidence of 12.0% in this study. Early identification of high-risk patients and appropriate perioperative infection-prevention measures are important for reducing SSI.
Recommendation
Strict adherence to aseptic surgical techniques, appropriate perioperative antibiotic prophylaxis, and meticulous postoperative wound care are recommended to reduce postoperative wound infection and improve patient outcomes.
References
1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20(4):250-278. https://doi.org/10.1086/501620
2. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections. Infect Control Hosp Epidemiol. 1992;13(10):606-608. https://doi.org/10.1086/646436
3. Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008;70(Suppl 2):3-10. https://doi.org/10.1016/S0195-6701(08)60017-1
4. World Health Organization. Global Guidelines for the Prevention of Surgical Site Infection. Geneva: WHO; 2018.
5. Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM, et al. New WHO recommendations on preoperative measures for surgical site infection prevention. Lancet Infect Dis. 2016;16(12):e276-e287. https://doi.org/10.1016/S1473-3099(16)30398-X
6. Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784-791. https://doi.org/10.1001/jamasurg.2017.0904
7. Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S66-S88. https://doi.org/10.1017/S0899823X00193869
8. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351(16):1645-1654. https://doi.org/10.1056/NEJMra040181
9. Trampuz A, Zimmerli W. Diagnosis and treatment of infections associated with fracture-fixation devices. Injury. 2006;37(Suppl 2):S59-S66. https://doi.org/10.1016/j.injury.2006.04.010
10. Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med. 2004;350(14):1422-1429. https://doi.org/10.1056/NEJMra035415
11. Tande AJ, Patel R. Prosthetic joint infection. Clin Microbiol Rev. 2014;27(2):302-345. https://doi.org/10.1128/CMR.00111-13
12. Metsemakers WJ, Morgenstern M, McNally MA, Moriarty TF, McFadyen I, Scarborough M, et al. Fracture-related infection: a consensus on definition from an international expert group. Injury. 2018;49(3):505-510. https://doi.org/10.1016/j.injury.2017.08.040
13. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty. 2008;23(7):984-991. https://doi.org/10.1016/j.arth.2007.10.017
14. Widmer AF. New developments in diagnosis and treatment of infection in orthopedic implants. Clin Infect Dis. 2001;33(Suppl 2):S94-S106. https://doi.org/10.1086/321863
15. National Institute for Health and Care Excellence. Surgical Site Infections: Prevention and Treatment (NG125). London: NICE; 2019.
16. World Health Organization. Global Report on Infection Prevention and Control. Geneva: WHO; 2022.
17. Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, et al. American College of Surgeons and Surgical Infection Society guidelines for surgical site infection. J Am Coll Surg. 2017;224(1):59-74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029
18. Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013;8(12):e83743. https://doi.org/10.1371/journal.pone.0083743
19. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-397. https://doi.org/10.1016/j.ajic.2008.12.010
20. Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2016;37(1):88-99. https://doi.org/10.1017/ice.2015.249
21. Fry DE. The importance of glycemic control in surgical patients. Surg Infect (Larchmt). 2015;16(3):235-241.
22. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2024;47(Suppl 1):S1-S350.
23. Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and smoking cessation. Arch Surg. 2012;147(4):373-383. https://doi.org/10.1001/archsurg.2012.5
24. Turan A, Mascha EJ, Roberman D, Turner PL, You J, Kurz A, et al. Smoking and perioperative outcomes. Anesthesiology. 2011;114(4):837-846. https://doi.org/10.1097/ALN.0b013e318210f560
25. Metsemakers WJ, Kuehl R, Moriarty TF, Richards RG, Verhofstad MHJ, Borens O, et al. Infection after fracture fixation: current surgical and microbiological concepts. Injury. 2018;49(3):511-522. https://doi.org/10.1016/j.injury.2016.09.019
26. Govaert GAM, Kuehl R, Atkins BL, Trampuz A, Morgenstern M, McNally MA, et al. Diagnosing fracture-related infection: current concepts. Injury. 2020;51(Suppl 2):S8-S17. https://doi.org/10.1097/BOT.0000000000001614
27. Cheng H, Chen BP, Soleas IM, Ferko NC, Cameron CG, Hinoul P. Prolonged operative duration increases risk of surgical site infections: a systematic review. Surg Infect (Larchmt). 2017;18(6):722-735. https://doi.org/10.1089/sur.2017.089
28. Peel TN, Buising KL, Choong PFM. Prosthetic joint infection: challenges of diagnosis and treatment. ANZ J Surg. 2011;81(1-2):32-39. https://doi.org/10.1111/j.1445-2197.2010.05541.x
29. Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations and management. Clin Microbiol Rev. 2015;28(3):603-661. https://doi.org/10.1128/CMR.00134-14
30. Otto M. Staphylococcal biofilms. Microbiol Spectr. 2018;6(4):GPP3-0023-2018. https://doi.org/10.1128/microbiolspec.GPP3-0023-2018
31. Parvizi J, Gehrke T. Definition of periprosthetic joint infection. J Arthroplasty. 2014;29(7):1331. https://doi.org/10.1016/j.arth.2014.03.009
32. Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery. Infect Control Hosp Epidemiol. 2002;23(4):183-189. https://doi.org/10.1086/502033
33. Badia JM, Casey AL, Petrosillo N, Hudson PM, Mitchell SA, Crosby C. Impact of surgical site infection on healthcare costs and patient outcomes. J Hosp Infect. 2017;96(1):1-15. https://doi.org/10.1016/j.jhin.2017.03.004
34. Lipsky BA, Dryden M, Gottrup F. Antimicrobial stewardship in wound management. J Antimicrob Chemother. 2016;71(11):3026-3035. https://doi.org/10.1093/jac/dkw287
35. Metsemakers WJ, Morgenstern M, Senneville E, Borens O, Govaert GAM, Onsea J, et al. General treatment principles for fracture-related infection. Injury. 2020;51(Suppl 2):S18-S22.
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