Incidence and risk factors for surgical site infection following open reduction and internal fixation of adult tibial plateau fractures
- 128 Downloads
The aim of this study was to identify independent risk factors for surgical site infection (SSI) and quantify the incidence of SSI in tibial plateau fractures after open reduction and internal fixation (ORIF).
This retrospective study was performed at a level 1 trauma centre from January 2015 to June 2016. Data of adult patients with tibial plateau fractures treated by ORIF were extracted from the electronic medical records. A total of 370 patients were collected. We reviewed the patients’ demographics, characteristics of fracture, treatment-related variables, and indexes of laboratory examination. Multivariate logistic analysis models were performed respectively to determine independent predictors of SSI.
Twenty-one patients developed SSI in this study. The overall incidence of SSI after ORIF of tibial fracture was 5.7%, with six (1.6%) for deep infection and 15 (4.1%) for superficial SSI. Independent predictors of SSI identified by multivariate analysis were open fracture (odds ratio=4.53; 95% CI=1.64-15.26; p=0.000), intra-operative duration (odds ratio=2.72; 95% CI=1.17-6.29; p=0.020), and smoking (odds ratio=4.79; 95% CI=1.46-15.73; p=0.010).
The SSI incidence was high (5.7%) after surgical tibial plateau fractures by ORIF and open fracture, operative time, and smoking were identified as independent related risk factors. Therefore, we recommend that a smoking cessation program is introduced immediately at the time of admission to hospital. More reasonable management strategies on open injury should be utilized to reduce the SSI rate.
KeywordsTibial plateau fractures Surgical site infection Incidence Risk factors
Yingze Zhang designed the study; Jia Li and Yanbin Zhu searched relevant studies; Bo Liu, Tianhua Dong and Wei Chen analyzed and interpreted the data; Jia Li and Yanbin Zhu wrote the manuscript and Yingze Zhang approved the final version of the manuscript.
Compliance with ethical standards
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Ethical board review statement
This material has not been published and is not under consideration elsewhere.
Conflicts of interest
Statement of human rights
For this type of study formal consent is not required.
- 1.Zhang Y (2016) Clinical epidemiology of orthopedic trauma. Thieme, StuggartGoogle Scholar
- 3.Zhu Y, Liu S, Zhang X, Chen W, Zhang Y (2017) Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study. Int Wound J. https://doi.org/10.1111/iwj.12743
- 4.Sciadini MF, Sims SH (2013) Proximal tibial intra-articular osteotomy for treatment of complex Schatzker type IV tibial plateau fractures with lateral joint line impaction: description of surgical technique and report of nine cases. J Orthop Trauma 27(1):e18–e23. https://doi.org/10.1097/BOT.0b013e31825316ea. CrossRefPubMedGoogle Scholar
- 25.Dubory A, Giorgi H, Walter A, Bouyer B, Vassal M, Zairi F, Dhenin A, Grelat M, Lonjon N, Dauzac C (2015) Surgical-site infection in spinal injury: incidence and risk factors in a prospective cohort of 518 patients. Eur Spine J 24(3):543–554. https://doi.org/10.1007/s00586-014-3523-4 CrossRefPubMedGoogle Scholar