Department of Micro Orthopedics, Shandong University of Traditional Chinese Medicine, Jinan, China.
Department of Micro Orthopedics, Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan, China.
Int Wound J. 2024 Apr;21(4):e14639. doi: 10.1111/iwj.14639. Epub 2023 Dec 28.
Surgical site infections (SSIs) following ankle fracture fixation pose significant challenges in patient recovery and healthcare management. Identifying risk factors contributing to SSIs can aid in developing targeted prevention and treatment strategies. This systematic review and meta-analysis were conducted according to the PRISMA guidelines and the PICO framework. A comprehensive literature search across major databases, including PubMed, Embase, Web of Science and the Cochrane Library, was completed on September 26, 2023. The inclusion criteria encompassed peer-reviewed studies of various designs that investigated risk factors for SSIs post-ankle fracture fixation. Quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analyses assessed heterogeneity and calculated combined effect sizes using fixed- or random-effects models, depending on the heterogeneity observed. The initial search yielded 1250 articles, with seven meeting the inclusion criteria after rigorous screening and full-text review. The included studies, conducted between 2006 and 2019, predominantly utilized case-control designs. The meta-analysis identified diabetes, open fractures, smoking, age, alcohol consumption, ASA score ≥3, high BMI, contaminated incisions, fracture dislocation and heart disease as significant risk factors for postoperative SSIs. Publication bias assessment showed no significant bias across studies. The identification of key risk factors such as diabetes, open fractures, smoking, advanced age, alcohol consumption, high ASA score, elevated BMI, contaminated incisions, fracture dislocation and heart disease is essential in managing SSIs post-ankle fracture fixation. Targeted interventions addressing these risk factors are crucial to reduce the incidence of SSIs and improve overall patient outcomes.
踝关节骨折固定术后的手术部位感染（SSI）给患者康复和医疗管理带来了重大挑战。确定导致 SSI 的风险因素有助于制定有针对性的预防和治疗策略。本系统评价和荟萃分析按照 PRISMA 指南和 PICO 框架进行。于 2023 年 9 月 26 日在主要数据库（包括 PubMed、Embase、Web of Science 和 Cochrane Library）中进行了全面的文献检索。纳入标准包括研究各种设计的同行评议文章，这些文章研究了踝关节骨折固定术后 SSI 的风险因素。使用纽卡斯尔-渥太华量表进行质量评估。统计分析评估了异质性，并根据观察到的异质性使用固定或随机效应模型计算了合并效应大小。最初的搜索产生了 1250 篇文章，经过严格的筛选和全文审查后，有 7 篇符合纳入标准。纳入的研究在 2006 年至 2019 年之间进行，主要采用病例对照设计。荟萃分析确定糖尿病、开放性骨折、吸烟、年龄、饮酒、ASA 评分≥3、高 BMI、污染切口、骨折脱位和心脏病是术后 SSI 的显著危险因素。研究间的发表偏倚评估显示无显著偏倚。确定糖尿病、开放性骨折、吸烟、高龄、饮酒、高 ASA 评分、高 BMI、污染切口、骨折脱位和心脏病等关键危险因素对于管理踝关节骨折固定术后的 SSI 至关重要。针对这些危险因素的靶向干预对于降低 SSI 的发生率和改善整体患者结局至关重要。
