Factors affecting the incidence of deep wound infection after hip fracture surgery.
Prospective data on 6905 consecutive hip fracture patients at a district general hospital were analysed to identify the risk factors for the development of deep infection post-operatively. The main outcome measure was infection beneath the fascia lata. A total of 50 patients (0.7%) had deep infection. Operations by consultants or a specialist hip fracture surgeon had half the rate of deep infection compared with junior grades (p = 0.01). Increased duration of anaesthesia was significantly associated with deep infection (p = 0.01). The method of fracture fixation was also significant. Intracapsular fractures treated with a hemiarthroplasty had seven times the rate of deep infection compared with those treated by internal fixation (p = 0.001). Extracapsular fractures treated with an extramedullary device had a deep infection rate of 0.78% compared with 0% for those treated with intramedullary devices (p = 0.02). The management of hip fracture patients by a specialist hip fracture surgeon using appropriate fixation could significantly reduce the rate of deep infection and associated morbidity, along with extended hospitalisation and associated costs.
Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough PE3 9GZ, UK. timharrison001@hotmail.com
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Robinson
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000592:standards; D002983:Clinical Competence; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000592:standards; D005594:Fracture Fixation, Intramedullary / Q000379:methods / Q000592:standards; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D013997:Time Factors; D055815:Young Adult