Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, NO.139 Ziqiang Road, Shijiazhuang, 050051, Hebei Province, China.
Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China.
Int Orthop. 2021 Aug;45(8):2129-2139. doi: 10.1007/s00264-021-05070-w. Epub 2021 May 20.
Surgical site infection (SSI) after patella fracture surgery could be devastating and challenging. There is no large sample size study to investigate the prevalence and risk factors of it. The purpose of this study was to address this clinical issue.
A total of 820 patients who underwent patella fracture surgery between October 2014 and December 2018, were included. Demographic data, fracture type, injury mechanism, pre-operative stay, surgery-related variables, and pre-operative laboratory indexes were obtained from a prospective database. The optimum cutoff value of surgery duration was detected by receiver operating characteristic analysis. Univariate analysis and multivariate analysis were performed to determine the risk factors.
A total of 17 patients developed SSI after patella fracture surgery, indicating a prevalence of 2.1%, with 11 cases (1.3%) for superficial infection and six cases (0.8%) for deep infection. After adjustment of multiple variables, current smoking, (OR, 18.6, CI, 3.5-99.0); albumin < 35 g/L, (OR, 7.4, CI, 1.1-52.3); diabetes mellitus, (OR, 8.8, CI, 1.3-59.4) and surgery duration > 79.5 minutes, (OR, 13.2, CI, 1.5-117.3) were identified to be independent risk factors of SSI after patella fracture surgery (p < 0.05).
The prevalence of SSI in patients with closed isolated patella fracture was 2.1%, with 1.3% for superficial and 0.8% for deep infection. We recommend individualized risk stratification and targeted interventions for patients with risk factors (current smoking, albumin < 35 g/L, diabetes mellitus, and surgery duration > 79.5 minutes).
髌骨骨折手术后的手术部位感染（SSI）可能是灾难性的，具有挑战性的。目前尚无大规模样本量研究来调查其患病率和危险因素。本研究旨在解决这一临床问题。
纳入 2014 年 10 月至 2018 年 12 月间接受髌骨骨折手术的 820 例患者。从前瞻性数据库中获取人口统计学数据、骨折类型、损伤机制、术前住院时间、手术相关变量和术前实验室指标。通过受试者工作特征分析检测手术时间的最佳截断值。进行单因素分析和多因素分析以确定危险因素。
髌骨骨折手术后共有 17 例发生 SSI，患病率为 2.1%，其中 11 例（1.3%）为浅表感染，6 例（0.8%）为深部感染。调整多个变量后，当前吸烟（OR，18.6，CI，3.5-99.0）、白蛋白<35g/L（OR，7.4，CI，1.1-52.3）、糖尿病（OR，8.8，CI，1.3-59.4）和手术时间>79.5 分钟（OR，13.2，CI，1.5-117.3）被确定为髌骨骨折手术后 SSI 的独立危险因素（p<0.05）。
闭合性孤立髌骨骨折患者 SSI 的患病率为 2.1%，其中浅表感染占 1.3%，深部感染占 0.8%。我们建议对有危险因素的患者（当前吸烟、白蛋白<35g/L、糖尿病和手术时间>79.5 分钟）进行个体化风险分层和针对性干预。
