Walter Sobba, Lawrence J Lin, Gerardo E Sanchez-Navarro, Jadie De Tolla, Omri Ayalon, Jacques H Hacquebord
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引用次数: 0
Abstract
Introduction: Managing open distal radius fractures (DRFs) poses challenges. While preventing surgical site infection (SSI) involves prompt antibiotic administration and thorough irrigation and debridement, the impact of urgent intervention on reducing postoperative infection rates is debated. We hypothesize that timing of surgery does not significantly affect the incidence of SSI in open DRF treated within or after 24 hours from time of injury.
Methods: We retrospectively analyzed the American College of Surgeons Trauma Quality Improvement Program from 2011 to 2021. We focused on outcome variables, including superficial SSI and deep SSI or osteomyelitis. To evaluate the relationship between time to operative intervention and SSI rates, we employed least absolute shrinkage and selection operator and multivariate regression models, adjusting for patient-specific factors and injury severity.
Results: A total of 14 486 patients were included. Regression modeling demonstrated a 23% increase in the odds of deep SSI with each 1-day delay in surgery (P = .010). However, no association was found between time to surgery and superficial SSI (odds ratio [OR] = 0.96, P = .768). Injury severity score (ISS) was associated with increased odds of superficial SSI (OR = 1.06, P < .001) and deep SSI (OR = 1.06, P < .001) while diabetes (OR = 3.56, P = .013) was significantly associated with increased rates of superficial SSI.
Conclusions: Extended time to surgery correlates with a modest rise in deep SSI incidence in open DRF. However, there was no heightened risk of superficial SSI in patients with delayed surgery. Polytrauma, alcohol use disorder, and diabetes were linked to elevated SSI rates in open DRF.
期刊介绍:
HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.