POST-OSTEOSYNTHESIS INFECTION: EVALUATION OF A HISTORICAL COHORT AND DEVELOPMENT OF A CARE PROTOCOL.

Abstract

Objective: To evaluate patients with post-osteosynthesis infection (POI) in the appendicular skeleton, in a tertiary hospital, and to develop a care protocol for case management, based on cohort data and agreement between attending physicians.

Method: primary, observational, retrospective and comparative study, evaluating cases of POI, from 2014 to 2019, assisted by the service. The outcomes analyzed were length of stay, readmission, fracture site, etiological agent, antibiotic therapy, number of surgeries and clinical outcome after one year (cure or failure, these considered recurrence, amputation or death). Based on this data, a protocol for diagnosing and treating POI was proposed to the institution's orthopedists, with responses assessed in terms of the content validity coefficient, in order to grade compliance with the protocol.

Results: sample of 27 participants, mostly male, with infection in the lower limbs (77.8%), who underwent an average of two surgeries. The average length of stay was 48 days. The median duration of antibiotic therapy was 34 days. Patients with cure criteria used a greater amount of antibiotics compared to other cases (p<0.05). The responses of orthopedists to the management protocol for these cases reached a concordance of 0.91.

Conclusion: The profile of patients and therapy to POI was similar to the literature and supported the development of the care protocol, with high agreement among developers. Level of Evidence III; Observational, Retrospective and Comparative Study.