title: Risk factors for surgical site infection of pilon fractures.
abstract: OBJECTIVE
  Pilon fracture is a complex injury that is often associated with severe soft tissue damage and high rates of surgical site infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among patients undergoing surgical fixation of a pilon fracture.
  
  
  METHODS
  The medical records of all pilon fracture patients who underwent surgical fixation from January 2010 to October 2012 were reviewed to identify those who developed a surgical site infection. Then, we constructed univariate and multivariate logistic regressions to evaluate the independent associations of potential risk factors with surgical site infection in patients undergoing surgical fixation of a pilon fracture.
  
  
  RESULTS
  A total of 519 patients were enrolled in the study from January 2010 to October 2012. A total of 12 of the 519 patients developed a surgical site infection, for an incidence of 2.3%. These patients were followed for 12 to 29 months, with an average follow-up period of 19.1 months. In the final regression model, open fracture, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were significant risk factors for surgical site infection following surgical fixation of a pilon fracture.
  
  
  CONCLUSIONS
  Open fractures, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were related to an increased risk for surgical site infection following surgical fixation of a pilon fracture. Patients exhibiting the risk factors identified in this study should be counseled regarding the possible surgical site infection that may develop after surgical fixation.
authors.affiliation: Department of Intensive Care Unit South Campus, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Ren
authors.affiliation: Department of Orthopaedics, Shanghai Fengxian Central Hospital, Shanghai, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Orthopaedics, Shanghai Fengxian Central Hospital, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Orthopaedics, Shanghai Fengxian Central Hospital, Shanghai, China.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Orthopaedics, Shanghai Fengxian Central Hospital, Shanghai, China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Xiao
mesh_terms: D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000627:therapeutic use; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D005597:Fractures, Open / Q000150:complications / Q000601:surgery*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D008499:Medical Records; D015999:Multivariate Analysis; D061646:Operative Time; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology*; D013978:Tibial Fractures / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D002437:Cefazolin