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Risk factors for surgical site infection of pilon fractures
Tingting Ren1, Liang Ding2, Feng Xue2
1Department of Intensive Care Unit South Campus, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
Insights
Surgical site infection risk after pilon fracture fixation is linked to open fractures, high postoperative glucose, and long surgery times. Patients with these factors need counseling on potential infection risks.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
Background:
- Pilon fractures are complex lower-extremity injuries.
- Associated soft tissue damage increases surgical site infection (SSI) risk.
- Identifying SSI risk factors is crucial for patient management.
Purpose of the Study:
- To identify independent risk factors for surgical site infection (SSI) in pilon fracture patients.
- To analyze patient data for associations between pre-operative and intra-operative factors and SSI development.
Main Methods:
- Retrospective review of 519 pilon fracture patients undergoing surgical fixation (Jan 2010 - Oct 2012).
- Univariate and multivariate logistic regression analyses were used.
- Evaluation of potential risk factors for SSI development.
Main Results:
- The overall incidence of surgical site infection was 2.3% (12/519 patients).
- Significant risk factors identified: open fracture, elevated postoperative glucose (≥125 mg/dL), and surgery duration >150 minutes.
- Average follow-up was 19.1 months.
Conclusions:
- Open fractures, elevated postoperative glucose, and prolonged surgery increase SSI risk after pilon fracture fixation.
- Patients with identified risk factors require counseling on potential SSI development.
- These findings aid in risk stratification and patient education.
Objectives:
Pilon fracture is a complex injury that is often associated with severe soft tissue damage and high rates of surgical site infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among patients undergoing surgical fixation of a pilon fracture.
Methods:
The medical records of all pilon fracture patients who underwent surgical fixation from January 2010 to October 2012 were reviewed to identify those who developed a surgical site infection. Then, we constructed univariate and multivariate logistic regressions to evaluate the independent associations of potential risk factors with surgical site infection in patients undergoing surgical fixation of a pilon fracture.
Results:
A total of 519 patients were enrolled in the study from January 2010 to October 2012. A total of 12 of the 519 patients developed a surgical site infection, for an incidence of 2.3%. These patients were followed for 12 to 29 months, with an average follow-up period of 19.1 months. In the final regression model, open fracture, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were significant risk factors for surgical site infection following surgical fixation of a pilon fracture.
Conclusions:
Open fractures, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were related to an increased risk for surgical site infection following surgical fixation of a pilon fracture. Patients exhibiting the risk factors identified in this study should be counseled regarding the possible surgical site infection that may develop after surgical fixation.
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