A study of incidence and risk factors of Surgical site infection following orthopedic surgical procedure in a tertiary care hospital in south India

  • Dr Ali Mohammed P Senior Resident, Department of orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry ( JIPMER) Pondicherry, India
  • Dr Deep Sharma Associate Professor, Department of orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry ( JIPMER) Pondicherry, India
  • Dr D K Patro Senior Professor, Department of orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry ( JIPMER) Pondicherry, India
  • DR Jagdish Menon Head, Department of orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry ( JIPMER) Pondicherry, India
  • Dr Murali Poduval Associate Professor, Department of orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry ( JIPMER) Pondicherry, India
Keywords: Surgical site infection, risk factors, orthopedic surgeries

Abstract

Introduction: Surgical site infection following orthopaedic surgeries is a particularly catastrophic complication. So identification and stratification of risk factors of surgical site infection is utmost important in implementation of measures to prevent surgical site infection.

Materials and Methods: This study was done in JIPMER Puducherry between January 2013 and August 2014. We aimed at identifying the incidence of surgical site infection and also tried to find out the factors associated with a higher risk for SSI. We studied a total of 249 patients, and collected their demographic data as per our proforma and at the end of the study data was compared among two groups of patients (patients with SSI vs Patients without SSI).

Results: We found in our study that the incidence of patients developing surgical site infection as 11.6% (29 patients). BMI (>25), use of C arm, duration of surgery (>3 hours), duration of closed suction drain (>2 days) and amount of collection of drain (>170 ml) are risk factors of post-operative wound discharge and infection.

Conclusion: The present study shows that incidence of surgical site infection in our patient population is11.6%, and out of various parameters studied we found that, BMI, use of C-arm, blood transfusion, duration of closed suction drain and amount of collection in suction drain to be important risk factors for the development of surgical site infection

Downloads

Download data is not yet available.

References

1. Merle V, Germain J.M, Chamouni P, Daubert .Assessment of prolonged hospital stay attributable to surgical site infections using appropriateness evaluation protocol. Am J Infect cont.2000;28(2): 109-15. [PubMed]

2. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection. Hospital Infection Control Practices Advisory Committee. Infect. Control Hosp. Epidemiol.1999;20:250–278.

3. Prokuski L. Prophylactic antibiotics in orthopaedic surgery. J Am Acad Orthop Surg.2008; 16:283–293. [PubMed]

4. Broex EC, van Asselt AD, Bruggeman CA, van Tiel FH. Surgical site infections, how high are the costs?. J. Hosp. Infect.2009;72:193–201. [PubMed]

5. Pittet D, Harbarth S, Ruef C et al. Prevalence and risk factors for nosocomial infections in four university hospitals in Switzerland. Infect Control Hosp. Epidemiol. 1999;20:37–42. [PubMed]

6. Jadranka Maksimovic, Ljiljana Markovic-Denic, Marko Bumbasirevic, Jelena Marinkovic, Hristina Lajinac.Surgical site infections in orthopedic patients. Prospective cohort study.2008;49:58-65. [PubMed]

7. Ayliffe GA. Role of the environment of the operating suite in surgical wound infection. Rev. Infect. Dis. 1991;13:800–804. [PubMed]

8. Ilker,Uckay,Stephan Harbarth,Robin Peter,Daniel Lew,Pierre Hoffmeyer,Didier Pittet. Preventing Surgical Site Infections.Expert Rew Anti Infect Ther. 2010; 8(6):657-670. [PubMed]

9. Pull ter,Gunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery.Spine.2009;34(13):1422–8.

10. Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R. Infection of the surgical site after arthroplasty of the hip.J Bone Joint Surg Br.2005;87(6):844-50. [PubMed]

11. Peters PG, Laughlin RT, Markert RJ, Nelles DB, Randall KL, Prayson MJ. Timing of C-arm drape contamination.Surg Infect. 2012;13(2):110–3. [PubMed]

12. Kaska. A standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy. Patient Safety in Surgery;2010:4-20.

13. Heiss MM, Mempel W, Jauch KW, et al. Beneficial effect of autologous blood transfusion on infectious complications after colorectalcancer surgery. Lancet.1993; 342:1328–1333.

14. Jensen LS, Andersen AJ, Christiansen PM, et al. Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery. Br J Surg.1992; 79:513–516.

15. Talbot TR, D’Agata EMC, Brinsko V, Lee B, Speroff T, Schaffner W. Perioperative blood transfusion is predictive of poststernotomy surgical site infection.marker for morbidity or true immunosuppressant? Clin Infect Dis Off Publ Infect Dis Soc Am. 2004;38(10):1378–82. [PubMed]

16. Vamvakas EC, Moore SB, Cabanela M. Blood transfusion and septic complications after hip replacement surgery. Transfusion (Paris).1995;35(2):150–6.) [PubMed]

17. R. Clifton, S.Haleem, A. McKee,M. J. Parker. Closed suction surgical wound drainage after hip fracture surgery.a systematic review and meta-analysis of randomized controlled trials: international Orthopaedics december 2008;32(6): 723-727.

18. Martyn J Parker, Vicki Livingstone, Rupert Clifton, Andrew McKee. Closed suction surgical wound drainage after orthopedic surgery.2007;4:4-5. [PubMed]

19. Qi-dong Zhang,MD,Wan-shou Guo, MD,Qian Zhang, PhD,Zhao-hui Liu, MD,Li-ming Cheng, MD,Zi-rong Li, MD.Comparison Between Closed Suction Drainage and Nondrainage in Total Knee Arthroplasty.The Journal of Arthroplasty .2011;26(8):1265–1272. [PubMed]

20. Margaret A. Olsen, Jeffrey J. Nepple, K. Daniel Riew, Lawrence G. Lenke, Keith H. Bridwell, Jennie Mayfield and Victoria J. Fraser. Risk Factors for Surgical Site Infection Following Orthopedic Spinal Operations.J Bone Joint Surg Am.2008; 90:62-69.

21. Lilani SP,Jangale N,Chowdhary A,Daver GB.Surgical site infection in clean and clean contaminated cases. Indian J Medical Microbiology.2005; 23(4):249-252. [PubMed]

22. Mangran AJ, Horan TC, Pearlson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection 1999. Infect Control Hosp Epidemiol. 1999; 20:247–278.
CITATION
DOI: 10.17511/ijmrr.2015.i9.182
Published: 2015-10-31
How to Cite
1.
Mohammed P A, Sharma D, Patro DK, Menon J, Poduval M. A study of incidence and risk factors of Surgical site infection following orthopedic surgical procedure in a tertiary care hospital in south India. Int J Med Res Rev [Internet]. 2015Oct.31 [cited 2024Nov.22];3(9):983-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/355
Section
Original Article