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Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
Published on: October 20, 2012
Surgical Wound Classification and Surgical Site Infections in the Orthopaedic Patient
Ikemefuna Onyekwelu1, Ramakanth Yakkanti1, Lauren Protzer1
1Department of Orthopaedic Surgery (Dr. Onyekwelu, Mr. Tucker, and Dr. Seligson), the School of Medicine (Dr. Yakkanti, Ms. Protzer, and Dr. Seligson), and the Department of Bioinformatics and Biostatistics (Ms. Pinkston), University of Louisville, Louisville, KY.
Introduction:
The Centers for Disease Control and Prevention created a surgical wound classification system (SWC: I, clean; II, clean/contaminated; III, contaminated; and IV, dirty) to preemptively identify patients at risk of surgical site infection (SSI). The validity of this system is yet to be demonstrated in orthopaedic surgery. We hypothesize a poor association between the SWC and the rate of subsequent SSI in orthopaedic trauma cases.
Methods:
Nine hundred fifty-six orthopaedic cases were reviewed. Wounds were risk stratified intraoperatively using the SWC grades (I-IV). SSI was diagnosed clinically or with objective markers. The SWC was compared with SSI rates using a Fisher exact test. Significance was set at P < 0.05.
Results:
Four hundred patients met the selection criteria. The rate of infection was not significantly different across the SWC grades (P = 0.270). There was a significantly higher risk of SSI among patients with diabetes (P = 0.028).
Conclusions:
The Centers for Disease Control and Prevention SWC showed poor utility in predicting and risk stratifying postoperative SSIs in orthopaedic surgical cases.
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