Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study

• Published in: Journal of orthopaedic surgery and research 2018-11, Vol.13 (1), p.293-293, Article 293
• Main Authors: Wang, Hui, Pei, Honglei, Chen, Meiyun, Wang, He
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Ankle; Calcaneus; Calcaneus - injuries; Calcaneus - surgery; Calcaneus fracture; Cardiovascular disease; Cohort analysis; Cohort Studies; Demography; Diabetes; Electronic medical records; Female; Fracture Fixation, Internal - adverse effects; Fracture Fixation, Internal - trends; Fractures; Fractures, Bone - diagnosis; Fractures, Bone - surgery; Hospitals; Humans; Hypothermia; Incidence; Infections; Male; Medical records; Middle Aged; Multivariate analysis; Open Fracture Reduction - adverse effects; Open Fracture Reduction - trends; Orthopedics; Patients; Predictive Value of Tests; Retrospective Studies; Risk factors; Substance abuse treatment; Surgeons; Surgery; Surgical site infection; Surgical site infections; Surgical Wound Infection - diagnosis; Surgical Wound Infection - epidemiology; Trauma; Wounds; Young Adult
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-018-1003-y

Occurrence of calcaneus fractures is on the up trend. Owing to its unique anatomical morphology and limited soft-tissue envelope, management of calcaneus fractures is a challenge to the orthopaedic surgeon, and surgical site infection (SSI) is one of the serious postoperative complications. In order to decrease the incidence of wound breakdown and improve clinical outcomes, it is necessary to understand which factors were associated with SSI. The aim of this study was to identify predictors of SSI and quantify the incidence of SSI in calcaneus fractures following open reduction and internal fixation (ORIF). This retrospective study was performed at a level 1 trauma center from January 2014 to June in 2017. Data of adult patients with calcaneus fractures treated by ORIF were extracted from the electronic medical records. A total of 681 patients were collected. We reviewed the patients' demographics, characteristics of fracture, treatment-related variables, and indexes of laboratory examination. Univariate and multivariate logistic analysis models were performed respectively to determine independent predictors of SSI. Sixty-six patients developed SSI in this study. The overall incidence of SSI after ORIF of calcaneus fracture was 9.7%, with 2.9% for deep infection and 6.8% for superficial SSI. Independent predictors of SSI identified by multivariate analysis were open fracture (odds ratio = 9.48, 95% CI = 4.53-19.85, P = 0.00007), high-energy injury (odds ratio = 2.07, 95% CI = 1.16-3.70, P = 0.01437), ASA class 3 or higher (odds ratio = 3.50, 95% CI = 1.18-10.37, P = 0.02401), and intraoperative temperature