Wound infection in the management of hip fractures: a comparison between low-molecular weight heparin and mechanical prophylaxis.
A review of 205 consecutive patients was carried out to determine the association of low molecular weight heparin (LMWH) and the development of wound infection in patients having undergone surgery for a femoral neck fracture: 114 patients treated with LMW Heparin (Group A) and 91 patients with mechanical prophylaxis (Group B). The wounds were assessed using the ASEPSIS Score. Deep vein thrombosis (DVT) and pulmonary embolism (PE) were also noted. Twenty-two patients (19%) in group A developed infection; 9 patients (8%) showed severe infection. Eight patients (8%) in group B developed infection; one patient (1%) showed severe infection. The differences between these two groups regarding infection (p < 0.034) and severity of the infection (p < 0.001) were statistically significant. None of the patients developed PE; however 9 patients were diagnosed with a DVT. Based on these findings, it appears that the use of LMWH for DVT prophylaxis may increase the likelihood of developing a severe wound infection.
Sanchez-Ballester
Jordi
J
Department of Orthopaedics, Royal Oldham Hospital, Rochdale Road, Oldham OL1 2JH, United Kingdom. jsballester@doctors.org.uk
Smith
Mathew
M
Hassan
Kamran
K
Kershaw
Steven
S
Elsworth
Chris S
CS
Jacobs
Leo
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001696:Biomechanical Phenomena; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005592:Fracture Fixation; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology*; D020246:Venous Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight