title: Risk factors for surgical site infection and delayed wound healing after orthopedic surgery in rheumatoid arthritis patients.
abstract: OBJECTIVE
  To investigate the prevalence and the risk factors of surgical-site infection (SSI) and delayed wound healing (DWH) in patients with rheumatoid arthritis (RA) underwent orthopedic surgery.
  
  
  METHODS
  We reviewed the records of 1036 elective orthopedic procedures undertaken in RA patients. Risk factors for SSI and DWH were assessed by logistic regression analysis using age, body mass index, disease duration, pre-operative laboratory data, surgical procedure, corticosteroid use, co-morbidity, and use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biological DMARDs (bDMARDs) as variables.
  
  
  RESULTS
  SSI and DWH were identified in 19 cases and 15 cases, respectively. One case of SSI and three cases of DWH were recorded among 196 procedures in patients using bDMARDs. Foot and ankle surgery was associated with an increased risk of SSI (odds ratio (OR), 3.167; 95% confidence interval (CI), 1.256-7.986; p = 0.015). Total knee arthroplasty (TKA; OR, 4.044; 95% CI, 1.436-11.389; p = 0.008) and disease duration (OR, 1.004; 95% CI, 1.000-1.007; p = 0.029) were associated with an increased risk of DWH.
  
  
  CONCLUSIONS
  Our results indicated foot and ankle surgery, and TKA and disease duration as risk factors for SSI and DWH, respectively. bDMARDs was not associated with an increased risk of SSI and DWH.
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kadota
authors.affiliation: a Department of Orthopedic Surgery and.|b Department of Human Morphology , Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences , Okayama City, Okayama , Japan , and.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hashizume
authors.affiliation: c Department of Orthopedic Surgery , Kurashiki Sweet Hospital , Kurashiki City, Okayama , Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nasu
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nakahara
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Ryozo
authors.initials: R
authors.lastname: Harada
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Machida
authors.affiliation: a Department of Orthopedic Surgery and.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: Biological DMARDs; Delayed wound healing; Orthopedic surgery; Rheumatoid arthritis; Surgical-site infection