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[Intraoperative bacterial contamination and posttraumatic wound infection (author's transl)]
Abstract:
In a consecutive series of 150 fractures treated surgically 16 wound infections were observed. Evaluating the intraoperative wound swabs, type and localisation of the fractures, duration of operation and tourniquet time it was tried retrospectively to find a relationship to these posttraumatic wound infections. The highest rate of infection was found in fractures of the tibia. Open fractures had a higher risk than closed ones. Furthermore, a prolonged duration of operation was related to a rising risk of infection. The intraoperative wound swabs themselves did not allow any conclusion concerning the risk of postoperative infection. Postoperative wound infections appeared nearly as frequent after negative as after positive intraoperative swab. Only the species of bacterias found intraoperatively allowed a conclusion concerning subsequent wound infection so far that after an intraoperative finding of gram-negative bacterias and - surprisingly - apathogenic sporogenic bacterias postoperative wound infections were observed more frequently than after finding other bacterias. In summary, however, the routine intraoperative wound swab does not seem to be suitable as a sreening-test for early recognation of impending postoperative wound infections.
Insights
Surgical site infections after fracture treatment are linked to tibia fractures and longer operation times. Routine intraoperative wound swabs are not reliable predictors of post-traumatic infections.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
Context:
- Post-traumatic wound infections are a significant complication following surgical fracture treatment.
- Identifying risk factors and reliable predictive markers for these infections is crucial for patient outcomes.
Purpose:
- To retrospectively analyze factors associated with post-traumatic wound infections in surgically treated fractures.
- To evaluate the utility of intraoperative wound swabs in predicting postoperative infection risk.
Summary:
- A series of 150 surgically treated fractures revealed 16 wound infections. Tibia fractures and open fractures exhibited higher infection rates. Prolonged operation duration correlated with increased infection risk.
- Intraoperative wound swabs generally did not predict postoperative infections; infection rates were similar for both positive and negative swabs.
- However, the presence of specific bacteria, including gram-negative and certain apathogenic sporogenic bacteria, intraoperatively was associated with a higher frequency of subsequent wound infections.
Impact:
- This study suggests that routine intraoperative wound swabs are not effective screening tools for predicting post-traumatic wound infections.
- Findings highlight tibia fractures, open fractures, and extended operative times as key risk factors for surgical site infections.
- Further research into specific bacterial indicators may offer more targeted predictive insights for infection risk stratification.