The effect of operative time on surgical-site infection following total shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2023-11, Vol.32 (11), p.2371-2375
• Main Authors: Schmitt, Mark W., Chenault, Parker K., Samuel, Linsen T., Apel, Peter J., Bravo, Cesar J., Tuttle, John R.
• Format: Article
• Language: English
• Subjects: ACS-NSQIP; inflection point; Operative time; reverse shoulder arthroplasty; shoulder arthroplasty; surgical-site infection
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2023.05.010

Many factors contribute to the risk of surgical-site infection (SSI) following total shoulder arthroplasty (TSA). Operative time is a modifiable factor that may contribute to SSI occurrence after TSA. This study aimed to determine the correlation between operative time and SSI following TSA. By use of the American College of Surgeons National Surgical Quality Improvement Program database, a total of 33,987 patient records were queried from 2006 to 2020 and sorted by operative time and the development of an SSI in the 30-day postoperative period. Odds ratios for the development of an SSI were calculated based on operative time. An SSI developed in the 30-day postoperative period in 169 of the 33,470 patients in this study, resulting in an overall SSI rate of 0.50%. A positive correlation was identified between operative time and the SSI rate. An inflection point was identified at an operative time of 180 minutes, with a significant increase in the rate of SSI occurrence for operative times >180 minutes. Increased operative time was shown to be strongly correlated with an increased risk of SSI within 30 days following surgery, with a significant inflection point at 180 minutes. The target operative time for TSA should be