Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
Int Orthop. 2019 Mar;43(3):713-718. doi: 10.1007/s00264-018-3996-6. Epub 2018 May 28.
The purpose of this study is to investigate and compare the surgical site infection (SSI) rates of children and adults after open tibia fracture at a single medical centre.
A retrospective study was performed on patients who sustained open tibia fractures and who received treatment at our hospital from 2012 to 2016. Data on age, gender, fracture site, Gustilo-Anderson grade, treatment management, and culture results from the infection site were recorded.
Overall, 37 children with a mean age of 7.19 ± 2.28 years and 89 adults with a mean age of 40.38 ± 13.53 years were enrolled. The rate of SSIs was 13.5% (6/37) in children, which was significantly lower than the 21.3% (19/89) rate in adults (p < 0.001). The mean number of days to discharge was 12.86 ± 10.25 in children, which was significantly lower than the mean of 28.67 ± 16.92 days in adults (p < 0.001). Furthermore, the average waiting time for soft tissue recovery before definitive surgery was 1.41 ± 1.79 and 8.42 ± 4.38 days in children and in adults, respectively, and the difference was significant (p < 0.001). Early infection occurred more frequently in adults (5/19) than in children (0/6). Staphylococcus aureus was the most commonly found pathogen in both groups.
The SSI rate of paediatric patients after open tibia fracture fixation is significantly lower than that of adults, and the prognosis of the former is superior. The results indicate a superior ability of soft tissue recovery and infection resistance after open tibia fracture fixation among children.
本研究旨在调查和比较单一医疗中心儿童和成人开放性胫骨骨折手术后的手术部位感染（SSI）率。
对 2012 年至 2016 年在我院接受治疗的开放性胫骨骨折患者进行回顾性研究。记录年龄、性别、骨折部位、Gustilo-Anderson 分级、治疗管理以及感染部位的培养结果等数据。
共纳入 37 例儿童（平均年龄 7.19±2.28 岁）和 89 例成人（平均年龄 40.38±13.53 岁）。儿童的 SSI 发生率为 13.5%（6/37），明显低于成人的 21.3%（19/89）（p<0.001）。儿童的平均出院天数为 12.86±10.25 天，明显低于成人的 28.67±16.92 天（p<0.001）。此外，儿童和成人接受确定性手术前软组织恢复的平均等待时间分别为 1.41±1.79 和 8.42±4.38 天，差异具有统计学意义（p<0.001）。成人（5/19）比儿童（0/6）更早发生早期感染。两组中最常见的病原体均为金黄色葡萄球菌。
儿童开放性胫骨骨折固定术后 SSI 发生率明显低于成人，且前者预后更佳。这些结果表明，儿童在开放性胫骨骨折固定术后具有更好的软组织恢复和抗感染能力。
