Surveillance of surgical site infections in orthopedic prosthetic surgery: a tool for identifying risk factors and improving clinical practice.

Martina Porretto, Flavio Parente, Filippo Del Puente, Andrea Parisini, Stefania Tigano, Mauro Nelli, Claudio Mazzola, Guido Damiani, Giulia Adriano, Marina Sartini, Emanuele Pontali, Maria Luisa Cristina, Silvia Boni
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Abstract

Introduction: Surgical site infections (SSIs) are among the most frequently encountered complications in prosthetic surgery, and are associated with increased hospitalization, costs and in-hospital mortality. There is no national system for the comprehensive monitoring of the incidence of SSIs.

Methods: All patients undergoing orthopedic prosthetic surgery from April 1 to June 30, 2023 were enrolled. Clinical evaluation of the surgical site was conducted at 30 days, and a follow-up telephone interview was carried out by means of a specially designed questionnaire at 90 days.

Results: A total of 59 patients were included. Surgery was performed on the knee in 71.19% and on the hip in 28.81%. The patients' mean BMI was 28.25 ± 2.97, and their mean ASA score was 2.67 ± 0.58. Six patients had diabetes mellitus. The incidence of SSIs was 5.08%; two infections occurred in knee prosthesis surgery and one in hip surgery. Analysis of the data revealed that diabetes was the main risk factor for the development of infection.

Conclusions: Although based on a small number of patients, these results are encouraging, especially considering that the patients had an average ASA score of more than 2 and a high BMI. However, to further reduce the risk of infection, improved hygiene measures have now been implemented in the operating room and the antibiotic prophylaxis protocol has been updated to take into account the potential for MRSA colonization.

骨科修复手术中手术部位感染的监测:确定风险因素和改进临床实践的工具。
导言:手术部位感染(SSI)是假体手术中最常见的并发症之一,与住院时间、费用和院内死亡率的增加有关。目前还没有一个全面监测 SSI 发生率的全国性系统:所有在 2023 年 4 月 1 日至 6 月 30 日期间接受假体矫形手术的患者均被纳入调查范围。30天后对手术部位进行临床评估,90天后通过专门设计的问卷进行电话随访:结果:共纳入 59 名患者。结果:共纳入 59 名患者,其中膝关节手术占 71.19%,髋关节手术占 28.81%。患者的平均体重指数为 28.25 ± 2.97,平均 ASA 评分为 2.67 ± 0.58。六名患者患有糖尿病。SSI 发生率为 5.08%,其中 2 例发生在膝关节假体手术中,1 例发生在髋关节手术中。数据分析显示,糖尿病是发生感染的主要风险因素:这些结果虽然基于少数患者,但令人鼓舞,尤其是考虑到患者的平均ASA评分超过2分,且体重指数较高。不过,为了进一步降低感染风险,手术室现已采取了更好的卫生措施,并更新了抗生素预防方案,以考虑到 MRSA 定植的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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