title: Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implant materials.
abstract: OBJECTIVE
  In recent guidelines, smoking is reported as a factor increasing the risk of surgical site infection (SSI). The accurate analysis of the literature shows that this recommendation relies on low level of evidence in orthopaedic surgery with material implantation (arthroplasty components or implants for internal fixation). This study aimed to assess the attributable risk of smoking on organ/space SSI in orthopaedic surgery with implants.
  
  
  METHODS
  Risk factors of organ/space SSI were studied in a prospective cohort including 3,908 patients from June 2003 to December 2006.
  
  
  RESULTS
  Smoking was found as a significant risk factor for organ/space SSI. We also observed a significant difference between smokers and non-smokers for surgical wound complications (hematoma, discharge or wound dehiscence) during the period between surgical procedure and discharge from hospital.
  
  
  CONCLUSIONS
  This is the first large prospective report of a significant association between smoking and organ/space SSI in orthopaedic surgery with implants.
authors: Department of Infectious Diseases, University Hospital and University Jean Monnet, Saint-Etienne, France.
authors: François
authors: F
authors: Durand
authors: Philippe
authors: P
authors: Berthelot
authors: Celine
authors: C
authors: Cazorla
authors: Frederic
authors: F
authors: Farizon
authors: Frederic
authors: F
authors: Lucht
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005602:France; D006406:Hematoma / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology*