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[Risk factors for the development of surgical wound infections in patients with closed fractures]
J Quiroz-Williams1, G Antonio-Flores1, S Gaytán-Fernández1
1Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia «Manuel Ávila Camacho», Instituto Mexicano del Seguro Social, Puebla, Puebla, México.
Introduction:
orthopedic device-associated infections (ODI) are considered surgical site infections (SSI). SSIs are generally attributed to contamination during surgery, but they require certain factors for their development. Therefore, the objective of this study was to analyze the risk factors for the development of SSIs in patients with closed fractures.
Material And Methods:
a retrospective observational study was carried out, where records of patients with closed bone fractures undergoing surgery were reviewed during the period from January to December 2020. The variables studied were age, sex, BMI, comorbidities, as well as surgery time, ischemia time, intraoperative bleeding, type of fracture, serum glucose 24-48 hours prior to surgery and blood transfusion. The analysis was performed with Fisher, OR and binary logistic regression. Accepted statistical value: p < 0.05.
Results:
sample of 131 patients. Mean age was 47.6 ± 18.7 years. Diabetes mellitus (DM) 24.4%, systemic arterial hypertension (SAH) 23.7%, obesity 70.2%, smoking 47.3% and alcoholism 67.9%. Simple fractures 34.4% and complex 65.6%. 19.1% presented infection after surgery. Risk factors found: glucose > 120 mg/dl OR: 4.9 (95% CI, 1.6-15.7, p = 0.001), surgery time > 120 minutes OR: 6.7 (95% CI, 2.3-20.1, p = 0.001), male sex OR: 4.5 (95% CI, 1.5-13.9, p = 0.009) and age < 50 years OR: 0.3 (95% CI, 0.07-0.8, p = 0.031).
Conclusions:
having a glucose > 120 mg/dl before surgery and a surgical time > 120 minutes as risk factors for the development of ODI in closed long bone fractures.
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