Does early wound infection after elective orthopaedic surgery lead on to chronic sepsis?
Infection is an uncommon, but occasionally devastating, complication of orthopaedic surgery. The definition of post-operative infection remains problematic. A high rate of early post-operative sepsis has previously been reported using a clinical definition of wound infection as recommended by the Surgical Infection Study Group. The purposes of this study is to determine the rate of ongoing wound problems and deep sepsis 1 year after these early wound infections. Of 1131 consecutive orthopaedic procedures, there were 70 wound infections occurring within 30 days of surgery. Adequate follow-up data were obtained in 67 (97%) of the 69 patients alive at 1 year. Of these 67, three had definite evidence and two possible evidence of ongoing wound problems and/or deep sepsis. It is concluded that early post-operative wound infection as defined by the Surgical Infection Study Group is a poor predictor (4-10%) of ongoing wound problems and deep sepsis at 1 year. All of the confirmed cases of late sepsis were found to be associated with revision arthroplasty and/or pin tract sepsis.
Benger
J R
JR
Department of Orthopaedic Surgery, Southmead Hospital, Westbury on Trym, Bristol, UK.
Kelly
A J
AJ
Winson
I G
IG
D000368:Aged; D001178:Arthroplasty; D002908:Chronic Disease; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D012086:Reoperation; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013997:Time Factors