Factors associated with surgical site infection in patients with open tibial fractures.
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Abstract
Surgical site infection (SSI) is a common complication in patients with open tibial fractures and is associated with poor clinical outcomes. This study aimed to determine the incidence of SSI and identify factors associated with its occurrence in patients with open tibial fractures. A retrospective cohort study was conducted using medical records of patients admitted to Aranyaprathet Hospital between January 1, 2020, and December 31, 2024. Data collected included demographic characteristics, injury mechanisms, severity of open fractures according to the Gustilo–Anderson classification, treatment details, postoperative outcomes, and complications. Descriptive statistics were used to summarize patient characteristics, and logistic regression analysis was performed to assess the association between potential risk factors and SSI.
A total of 63 patients were included, with a mean age of 37 years (range, 18–51 years). Gustilo–Anderson grade III or higher open fractures were identified in 21 patients (33.3%). Surgical site infection occurred in 19 patients (30.2%), including 11 cases (57.9%) of superficial SSI and 8 cases (42.1%) of deep SSI. Logistic regression analysis demonstrated that Gustilo–Anderson grade III or higher was significantly associated with an increased risk of SSI (OR 246; 95% CI, 23.9–2528; P < 0.001). In contrast, a delay of more than 24 hours before surgical debridement was not significantly associated with the development of SSI (P = 0.375). In conclusion, severe open tibial fractures classified as Gustilo–Anderson grade III or higher represent a major risk factor for surgical site infection. These findings emphasize the importance of accurate injury severity assessment, meticulous wound management, and timely standardized treatment to reduce infection risk. However, the results should be interpreted with caution due to the retrospective design and relatively small sample size.
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เนื้อหาและข้อมูล (เขียนข้อกำหนด)
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