Surgical site infection complicating internal fixation of fractures: incidence and risk factors.
BACKGROUND
There is a dearth of data on surgical site infections (SSIs) complicating internal fixation of fractures from Nigeria.


OBJECTIVE
To determine the incidence and risk factors for SSIs following internal fixation of fracture.


METHODS
A cohort of 90 patients with long bone fractures that were stabilized internally with metallic devices was studied prospectively and retrospectively.


RESULTS
The incidence of SSI was 12%. The isolated organisms were Staphylococcus aureus in four patients, Pseudomonas spp. in three, and Escherichia coli in one patient. Diabetes mellitus and perioperative transfusion with allogeneic blood were not predictive of SSI. Duration of operation longer than 120 minutes was a strong predictor (OR 2.25, 95% CL 0.48-10.16). Other risk factors were male sex (OR 2.01, 95% CL 0.44-10.45), injury-operation interval less than six months (OR 2.00, 95% CL 0.22-46.08), fracture fixation with plates and screws (OR 1.51, 95% CL 0.36-6.40), white blood cell count (WBC) less than 5,000 per cumm (OR 1.50, 95% CL 0.15-16.37), preoperative urinary catheterization (OR 1.48, 95% CL 0.00-16.19), and postoperative urinary catheterization (OR 1.24, 95% CL 0.29-5.00).


CONCLUSIONS
The incidence of SSI after internal fixation of long bone fractures in our centers is 12%, and this is within the previously reported range. Use of plates and screws, WBC less than 5,000 per cumm, and perioperative urinary catheterization are important risk factors.
Department of Orthopedics and Traumatology, College of Health Sciences, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria. loathanni@yahoo.com
Lateef O A
LO
Thanni
Nofiu O
NO
Aigoro
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*