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Elevated risk of wound and systemic complications in MRSA-colonized patients undergoing lower extremity orthopedic

Aruni S Areti1, Harris Hafeez2, Pradyun V Sangineni2

  • 1Baylor College of Medicine, 1 Baylor Plz, Houston, TX, 77030, USA. aruni.areti@bcm.edu.

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
|July 27, 2026
PubMed
Abstract

Insights

Preoperative methicillin-resistant Staphylococcus aureus (MRSA) colonization increases risks for wound dehiscence, pneumonia, sepsis, and thromboembolic events in orthopedic trauma patients. Screening for MRSA may help stratify risk and optimize patient management.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Epidemiology
  • Trauma Care

Background:

  • Preoperative methicillin-resistant Staphylococcus aureus (MRSA) colonization is a known risk factor for adverse outcomes in arthroplasty.
  • Its impact on orthopedic trauma patients is less understood.
  • This study investigates MRSA's role in lower extremity trauma surgery complications.

Purpose of the Study:

  • To evaluate the impact of preoperative MRSA colonization on postoperative complication rates.
  • To identify specific complications associated with MRSA in orthopedic trauma.
  • To assess MRSA screening as a potential risk stratification tool.

Main Methods:

  • Retrospective cohort study using the TriNetX Research Network.
  • Matched 1:1 cohort of MRSA-positive and MRSA-negative patients undergoing lower extremity orthopedic trauma surgery.
  • Outcomes assessed within three months included surgical site infections, wound dehiscence, organ dysfunction, and thromboembolic events.

Main Results:

  • MRSA-positive patients had significantly increased risks of wound dehiscence, pneumonia, sepsis, and acute renal failure.
  • Increased odds of blood transfusion, deep vein thrombosis, and pulmonary embolism were observed in MRSA-positive patients.
  • No significant difference in surgical site infections was found between groups after matching.

Conclusions:

  • Preoperative MRSA colonization is linked to higher risks of systemic complications and thromboembolic events in orthopedic trauma.
  • Preoperative MRSA screening can aid in risk stratification and management optimization.
  • Targeted decolonization or prophylactic strategies may mitigate these risks.
Keywords:
MRSAOrthopedic traumaPostoperative complicationsPreoperative screening

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