[Infectious complications of surgically treated musculoskeletal injuries: review of risk factors and etiological agents in years 2000-2005].

PURPOSE

Infection is considered one of the most serious complications of the surgical treatment of musculoskeletal injuries. The aim of the study was to evaluate known risk factors and etiological agents of infectious complications in patients surgically treated for musculoskeletal injuries within 6 years.

METHODS

In a group of 5 234 patients followed in 2000-2005 the early or delayed infectious complication developed in 65 patients (26 women, 39 men, age 22-83 years). In every patient with infectious complication the important risk factors related to personal history, type of the injury, surgery and other treatment were recorded and microbiological culture results were collected.

RESULTS

In 60 patients (92.3%) at least one of the following risk factors was registered: diabetes mellitus, age above 75 years, abuse of alcohol and drugs, distant infectious focus or severe skin disease at the time of surgery, polytrauma requiring long-termed stay in intensive care unit, extensive soft tissue injury associated with closed or opened fracture. In 27 patients (41.5%) grampositive cocci and in 17 patients (26.2%) gramnegative bacteria were isolated, in 12 patients (18.5%) mixed bacterial flora was identified and 9 patients (13.8%) had negative cultures. The most severe findings from microbiological view occurred in patients with extensive soft tissue injury associated with fracture, diabetes or long-termed stay in intensive care unit.

CONCLUSION

The infectious complications after the surgical treatment of musculoskeletal injuries occurred predominantly in patients with risk factors. The extensive soft tissue injury associated with fracture, diabetes and long-termed stay of the polytrauma patient in intensive care unit were identified as the most frequent risk factors. The patients of these risk groups also presented with the most serious microbiological findings.