Nathan P. Olszewski, Joseph M Sliepka, Joseph J. Bigham, Reza Firoozabadi, Michael J. Githens, Milton “Chip” Routt, Conor P Kleweno
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Exclusion criteria were non-operative management of the pelvic ring, isolated posterior fixation, and follow-up less than 90 days.\n Outcome Measure and Comparisons: Primary outcome measured was deep infection of the anterior pelvis requiring surgical irrigation and debridement.\n \n \n \n 106 patients with anterior stabilization of the pelvis in the setting of a bladder injury were included. 7 (6.6%) patients developed a deep infection and required surgical debridement within 90 days. Patients undergoing open reduction and internal fixation (ORIF) with plating of the anterior pelvis and acute concomitant bladder repair had an infection rate of 2.2% (1/43). Patients undergoing closed reduction and anterior fixation with either external fixation or percutaneous rami screw post bladder repair had an infection rate of 17.6% (3/17). There was a higher infection rate among patients with combined intraperitoneal (IP) and extraperitoneal (EP) bladder injuries (23%) when compared to those with isolated EP (3.8%) or IP (9.1%) bladder injuries (p=0.029).\n \n \n \n Acute ORIF of the anterior pelvis in patients with combined pelvic ring and bladder injuries has a low infection rate. Patients with combined IP and EP bladder injuries are at increased risk of infection compared to those with isolated IP and EP injuries.\n \n \n \n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.\n","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated with Infection in Patients with Combined Pelvic Ring and Bladder Injuries\",\"authors\":\"Nathan P. Olszewski, Joseph M Sliepka, Joseph J. Bigham, Reza Firoozabadi, Michael J. Githens, Milton “Chip” Routt, Conor P Kleweno\",\"doi\":\"10.1097/bot.0000000000002846\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n To identify the infection rate in patients with combined pelvic ring and bladder injuries. 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引用次数: 0
摘要
确定合并骨盆环和膀胱损伤患者的感染率。次要目的包括确定与感染相关的治疗和损伤因素。 设计:回顾性研究 单个一级三级学术中心 对 12 年内所有合并骨盆环和膀胱损伤的患者进行了评估。排除标准为骨盆环未进行手术治疗、孤立的后固定术以及随访少于 90 天。结果测量和比较:主要测量结果是需要手术冲洗和清创的骨盆前部深度感染。 共纳入 106 名在膀胱损伤的情况下接受骨盆前路稳定术的患者。7例(6.6%)患者出现深度感染,需要在90天内进行手术清创。接受开放复位内固定术(ORIF)和骨盆前部钢板固定术并同时接受急性膀胱修复术的患者感染率为2.2%(1/43)。在膀胱修复术后接受闭合复位和前路固定术(外固定或经皮髂骨螺钉)的患者感染率为17.6%(3/17)。合并腹膜内(IP)和腹膜外(EP)膀胱损伤的患者感染率(23%)高于单独腹膜外(EP)(3.8%)或腹膜内(IP)膀胱损伤(9.1%)的患者(P=0.029)。 合并骨盆环和膀胱损伤患者的急性骨盆前部手术切除术感染率较低。与孤立的 IP 和 EP 损伤相比,合并 IP 和 EP 膀胱损伤的患者感染风险更高。 治疗级别 III。有关证据等级的完整描述,请参阅 "作者须知"。
Factors Associated with Infection in Patients with Combined Pelvic Ring and Bladder Injuries
To identify the infection rate in patients with combined pelvic ring and bladder injuries. Secondary aims included identifying treatment and injury factors associated with infection.
Design: Retrospective Review
Single Level I Tertiary Academic Center
All patients over a 12-year period with combined pelvic ring and bladder injuries were evaluated. Exclusion criteria were non-operative management of the pelvic ring, isolated posterior fixation, and follow-up less than 90 days.
Outcome Measure and Comparisons: Primary outcome measured was deep infection of the anterior pelvis requiring surgical irrigation and debridement.
106 patients with anterior stabilization of the pelvis in the setting of a bladder injury were included. 7 (6.6%) patients developed a deep infection and required surgical debridement within 90 days. Patients undergoing open reduction and internal fixation (ORIF) with plating of the anterior pelvis and acute concomitant bladder repair had an infection rate of 2.2% (1/43). Patients undergoing closed reduction and anterior fixation with either external fixation or percutaneous rami screw post bladder repair had an infection rate of 17.6% (3/17). There was a higher infection rate among patients with combined intraperitoneal (IP) and extraperitoneal (EP) bladder injuries (23%) when compared to those with isolated EP (3.8%) or IP (9.1%) bladder injuries (p=0.029).
Acute ORIF of the anterior pelvis in patients with combined pelvic ring and bladder injuries has a low infection rate. Patients with combined IP and EP bladder injuries are at increased risk of infection compared to those with isolated IP and EP injuries.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.