The study of risk factors and cause of post operative wound infection in Orthopaedics surgery cases
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Abstract
Osteomyelitis following open fracture is common. The primary aim of managing this condition is to control the infection before the bone fixation procedure is performed. The organisms of infection are different in each area, and an increase in the Pseudomonas infection rate was shown. Method: An analytical study by the case-control method was applied in this study. Between 2562 and 2567, we treated 978 patients with bone fractures (both open and closed) in our unit. The management of patients with fractures had two options: conservative or surgical treatment. Patients with Pseudomonas infection or non-Pseudomonas infection were divided, and exposure to risk factors was reviewed. The risk factors that were age, underlying disease, fracture type, type of antibiotic drug, and time to operation were predicted.
These results found that 242 patients who developed osteomyelitis were treated. Pseudomonas aeruginosa (P. aeruginosa) (65%) was the most common organism cultured. Age and gender were not significant risk factors, but the significant risk factors in this study were chronic kidney disease , diabetes mellitus type II , open fracture Gustilo III, and type of prophylactic antibiotic drug.
Conclusion: The management of a patient who has a tibia fracture should be carefully evaluated. The rate of Pseudomonas infection was increased in patients with chronic kidney disease, diabetes mellitus type II , open fracture Gustilo III, and type of antibiotic drug in this study. The risk factor should be awareness, and prophylactic treatment must be effective in controlling infection in tibial fractures. The best choice of treatment is prevention.
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References
John C. Weinlein. Fractures of the lower extremity. Campbell's Operative Orthopaedics, 12th Edition 2013;54:2644-2648.
Okapa R, Rak S, Wenda J, Marczyński W, Walczak P, Macias J. Septic complications after multilocal fractures and multiple traumatic injury.Chir Narzadow Ruchu Ortop Pol. 2011 Jul-Aug;76(4):214-8. Polish.
Jason H. Calhoun, M.D. Osteomyelitis of the Long Bones. F.A.C.S.,M.M. Manring, Ph.D. and Mark Shirtliff, Ph.D. Semin Plast Surg. 2009 May; 23(2): 59–72
Oginni LM, Bamgboye EA, Ako-Nai AK, Onipede AO. The bacteriology of open fractures in Ile-Ife, Nigeria.Ikem IC Niger J Med. 2004 Oct-Dec;13(4):359-65. Erratum in: Niger J Med. 2005 Oct-Dec;14(4):461. Onipade, AO [corrected to Onipede, AO].
Yusof NM, Halim AS.Outcomes of infected grade IIIB open tibial fractures. Singapore Med J. 2012 Sep;53(9):591-4.
Ring J, Seifert J, van Thiel D, Lob G, Probst J.Fortschr Med.Chronic posttraumatic osteomyelitis. Clinical aspects and bacteriology]. 1976 Jan 8;94(1):3-6. German.
Russell TA. Rockwood and Green's Fractures in Adults. 8 ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams&Wilkins;2015.2075-130p
Matthew I. Rudloff , Chapter 54 Fracture of the lower extremities, Cambell : 2702-2704
Berkes M, Obremskey WT, Scannell B, Ellington JK, Hymes RA, Bosse M.Maintenance of hardware after early postoperative infection following fracture internal fixation. Southeast Fracture Consortium.J Bone Joint Surg Am. 2010 Apr;92(4):823-8. doi: 10.2106/JBJS.I.00470.
Gross T, Kaim AH, Regazzoni P, Widmer AF. Current concepts in posttraumatic osteomyelitis: a diagnostic challenge with new imaging options. J Trauma. 2002 Jun. 52(6):1210-9.
Glass GE, Barrett SP, Sanderson F, Pearse MF, Nanchahal J. The microbiological basis for a revised antibiotic regimen in high-energy tibial fractures: preventing deep infections by nosocomial organisms. J Plast Reconstr Aesthet Surg. 2011 Mar;64(3):375-80. doi: 10.1016/j.bjps.2010.05.037. Epub 2010 Jun 29.
