SURGICAL SITE INFECTIONS IN ORTHOPEDIC PROCEDURES: RISK FACTORS AND CLINICAL OUTCOMES IN TERTIARY CARE
Main Article Content
Keywords
Surgical site infection, orthopedic surgery, antibiotic prophylaxis, risk factors, healthcare surveillance
Abstract
Introduction: Surgical site infections (SSI) represent a significant complication in orthopedic surgery, contributing to increased morbidity, mortality, and healthcare costs. This study aimed to determine the incidence, identify risk factors, and evaluate management strategies of SSI following orthopedic procedures in an Indian tertiary care hospital setting.
Methods: A prospective hospital-based surveillance study was conducted at LNCT Medical College and Sewakunj Hospital, Indore, from April to September 2022. Three hundred fifteen patients undergoing various orthopedic procedures were enrolled using consecutive sampling. Data collection included demographic characteristics, comorbidities, surgical details, and postoperative surveillance using CDC criteria. Univariate and multivariate logistic regression analyses identified independent risk factors for SSI development.
Results: The overall SSI rate was 8.9% (28/315 cases, 95% CI: 6.0-12.6%). External fixation procedures showed the highest infection rate (17.9%), followed by spine surgery (12.9%). Emergency procedures had significantly higher SSI rates compared to elective surgeries (12.8% vs 5.0%, p=0.016). Multivariate analysis identified five independent risk factors: inadequate antibiotic prophylaxis (OR 3.82, p=0.005), diabetes mellitus (OR 2.84, p=0.014), ASA score ≥III (OR 2.65, p=0.033), emergency surgery (OR 2.48, p=0.047), and hypoalbuminemia (OR 2.41, p=0.045). Staphylococcus aureus was the predominant pathogen (39.3%) with 36.4% MRSA prevalence. Treatment success rate was 82.1%, though 57.1% required additional surgical interventions. SSI resulted in 285% cost increase and 14.8-day hospital stay extension.
Conclusion: This study identified significant SSI burden in orthopedic procedures with modifiable risk factors, particularly inadequate prophylaxis. Targeted prevention strategies addressing identified risk factors could substantially reduce infection rates and healthcare costs.
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