From the Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN.
J Am Acad Orthop Surg Glob Res Rev. 2023 Mar 8;7(3). doi: 10.5435/JAAOSGlobal-D-23-00015. eCollection 2023 Mar 1.
INTRODUCTION: Surgical site infections (SSIs) are associated with patient morbidity and increased healthcare costs. Limited literature in foot and ankle surgery provides guidance about routine administration of postoperative antibiotic prophylaxis. The purpose of this study was to examine the incidence and revision surgery rates of SSI in outpatient foot and ankle surgeries in patients not receiving oral postoperative antibiotic prophylaxis. METHODS: A retrospective review of all outpatient surgeries (n = 1517) conducted by a single surgeon in a tertiary referral academic center was conducted through electronic medical records. Incidence of SSI, revision surgery rate, and associated risk factors were determined. The median follow-up was 6 months. RESULTS: Postoperative infection occurred in 2.9% (n = 44) of the surgeries conducted, with 0.9% of patients (n = 14) requiring return to the operating room. Thirty patients (2.0%) were diagnosed with simple superficial infections, which resolved with local wound care and oral antibiotics. Diabetes (adjusted odds ratio, 2.09; 95% confidence interval, 1.00 to 4.38; P = 0.049) and increasing age (adjusted odds ratio, 1.02; 95% confidence interval, 1.00 to 1.04; P = 0.016) were significantly associated with postoperative infection. DISCUSSION: This study demonstrated low postoperative infection and revision surgery rates without the routine prescription of prophylactic postoperative antibiotics. Increasing age and diabetes are signficant risk factors for developing a postoperative infection.
简介:手术部位感染(SSI)与患者发病率和增加的医疗保健成本有关。足部和踝关节手术方面的文献有限,提供了关于常规术后抗生素预防用药的指导。本研究的目的是检查未接受口服术后抗生素预防的门诊足部和踝关节手术患者的 SSI 发生率和翻修手术率。
方法:通过电子病历对一名外科医生在三级转诊学术中心进行的所有门诊手术(n = 1517)进行回顾性研究。确定 SSI 的发生率、翻修手术率和相关的危险因素。中位随访时间为 6 个月。
结果:术后感染发生在 2.9%(n = 44)的手术中,0.9%(n = 14)的患者需要返回手术室。30 名患者(2.0%)被诊断为单纯浅表感染,通过局部伤口护理和口服抗生素即可治愈。糖尿病(调整后的优势比,2.09;95%置信区间,1.00 至 4.38;P = 0.049)和年龄增长(调整后的优势比,1.02;95%置信区间,1.00 至 1.04;P = 0.016)与术后感染显著相关。
讨论:本研究表明,在不常规开具预防性术后抗生素的情况下,术后感染和翻修手术率较低。年龄增长和糖尿病是发生术后感染的显著危险因素。
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