Abstract
Postoperative surgical site infection (SSI) in orthopaedic trauma surgery is uncommon,
but can present serious complications. This study was designed to assess the prevalence
of, and to identify the risk factors for, SSI following acetabular fracture open reduction
and internal fixation. A total of 326 consecutive patients who underwent acetabular
fracture surgery were retrospectively reviewed. There were 17 patients (5.2%) who
developed a SSI, including 10 deep infections and 7 superficial infections. Staphylococcus
aureus was the most common causative pathogens in 9 patients, and was Methicillin-resistant
in 3 patients. Enterococcus faecalis was found in 6 patients, Staphylococcus epidermidis
in 3 patients, and Pseudomonas aeruginosa and enterbacter cloacae in 2 patients each.
Fourteen of 17 patients developed their infection within 4 weeks after the fixation.
Univariate analysis demonstrated that the SSI group had statistically significant
higher Injury Severity Score, longer intensive care unit (ICU) stays, larger amount
of packed red blood cells transfused, longer operative time, larger estimated operative
blood loss, higher body mass index (BMI), more frequent performance of combined approach,
embolisation of internal iliac arteries, association of urinary tract injury, and
Morel-Lavallée lesion compared to the no SSI group. Multivariate analysis using these
10 parameters showed that BMI, ICU stay, and Morel-Lavallée lesion were independently
significant risk factors for SSI. To reduce the incidence of SSI following acetabular
fracture surgery, special attention should be directed at the care of obese patients,
patients requiring ICU care, and patients with associated Morel-Lavallée lesions.
Keywords
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Article info
Publication history
Accepted:
November 17,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
