Nathan P. Olszewski, Joseph M Sliepka, Joseph J. Bigham, Reza Firoozabadi, Michael J. Githens, Milton “Chip” Routt, Conor P Kleweno
{"title":"Factors Associated with Infection in Patients with Combined Pelvic Ring and Bladder Injuries","authors":"Nathan P. Olszewski, Joseph M Sliepka, Joseph J. Bigham, Reza Firoozabadi, Michael J. Githens, Milton “Chip” Routt, Conor P Kleweno","doi":"10.1097/bot.0000000000002846","DOIUrl":null,"url":null,"abstract":"\n \n To identify the infection rate in patients with combined pelvic ring and bladder injuries. Secondary aims included identifying treatment and injury factors associated with infection.\n \n \n \n Design: Retrospective Review\n \n \n \n Single Level I Tertiary Academic Center\n \n \n \n All patients over a 12-year period with combined pelvic ring and bladder injuries were evaluated. Exclusion criteria were non-operative management of the pelvic ring, isolated posterior fixation, and follow-up less than 90 days.\n Outcome Measure and Comparisons: Primary outcome measured was deep infection of the anterior pelvis requiring surgical irrigation and debridement.\n \n \n \n 106 patients with anterior stabilization of the pelvis in the setting of a bladder injury were included. 7 (6.6%) patients developed a deep infection and required surgical debridement within 90 days. Patients undergoing open reduction and internal fixation (ORIF) with plating of the anterior pelvis and acute concomitant bladder repair had an infection rate of 2.2% (1/43). Patients undergoing closed reduction and anterior fixation with either external fixation or percutaneous rami screw post bladder repair had an infection rate of 17.6% (3/17). There was a higher infection rate among patients with combined intraperitoneal (IP) and extraperitoneal (EP) bladder injuries (23%) when compared to those with isolated EP (3.8%) or IP (9.1%) bladder injuries (p=0.029).\n \n \n \n Acute ORIF of the anterior pelvis in patients with combined pelvic ring and bladder injuries has a low infection rate. Patients with combined IP and EP bladder injuries are at increased risk of infection compared to those with isolated IP and EP injuries.\n \n \n \n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.\n","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Trauma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/bot.0000000000002846","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
To identify the infection rate in patients with combined pelvic ring and bladder injuries. Secondary aims included identifying treatment and injury factors associated with infection.
Design: Retrospective Review
Single Level I Tertiary Academic Center
All patients over a 12-year period with combined pelvic ring and bladder injuries were evaluated. Exclusion criteria were non-operative management of the pelvic ring, isolated posterior fixation, and follow-up less than 90 days.
Outcome Measure and Comparisons: Primary outcome measured was deep infection of the anterior pelvis requiring surgical irrigation and debridement.
106 patients with anterior stabilization of the pelvis in the setting of a bladder injury were included. 7 (6.6%) patients developed a deep infection and required surgical debridement within 90 days. Patients undergoing open reduction and internal fixation (ORIF) with plating of the anterior pelvis and acute concomitant bladder repair had an infection rate of 2.2% (1/43). Patients undergoing closed reduction and anterior fixation with either external fixation or percutaneous rami screw post bladder repair had an infection rate of 17.6% (3/17). There was a higher infection rate among patients with combined intraperitoneal (IP) and extraperitoneal (EP) bladder injuries (23%) when compared to those with isolated EP (3.8%) or IP (9.1%) bladder injuries (p=0.029).
Acute ORIF of the anterior pelvis in patients with combined pelvic ring and bladder injuries has a low infection rate. Patients with combined IP and EP bladder injuries are at increased risk of infection compared to those with isolated IP and EP injuries.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.