Tran Duy Nguyen Anh, Nguyen Bao Tu Thai, Nguyen Tan Thanh, Chen Yu-Pin, Kuo Yi-Jie
The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
EFORT Open Rev. 2024 Aug 1;9(8):817-826. doi: 10.1530/EOR-23-0139.
Studies have reported conflicting findings on the relationship between smoking and surgical site infection (SSI) post fixation for ankle and calcaneal fractures. This meta-analysis explored the effect of smoking on SSI incidence following open reduction and internal fixation (ORIF) of these fractures.
Full-text studies on smoking's influence on post-ORIF SSI rates for closed ankle and calcaneal fractures were sourced from the PubMed, Embase, and Cochrane databases, with no consideration given to language or publication date. Study quality was appraised using the Newcastle-Ottawa Scale. Odds ratios (OR) and the corresponding 95% CIs were determined using random-effects models. This meta-analysis adhered to the PRISMA guidelines and was registered with PROSPERO (CRD42023429372).
The analysis incorporated data from 16 cohort and case-control studies, totaling 41 944 subjects, 9984 of whom were smokers, with 956 SSI cases. Results indicated smokers faced a higher SSI risk (OR: 1.62; 95% CI: 1.32-1.97, P < 0.0001) post ORIF, with low heterogeneity (I 2 = 26%). Smoking was identified as a significant deep SSI risk factor (OR: 2.09; 95% CI: 1.42-3.09; P = 0.0002; I 2 = 31%). However, the subgroup analysis revealed no association between smoking and superficial SSI (OR: 1.05; 95% CI: 0.82-1.33; P = 0.70; I 2 = 0%).
Smoking is associated with increased SSI risk after ORIF for closed ankle and calcaneus fractures. Although no clear link was found between superficial SSI and smoking, the data underscore the negative influence of smoking on deep SSI incidence.
关于吸烟与踝关节和跟骨骨折内固定术后手术部位感染（SSI）之间的关系，研究报告的结果相互矛盾。本荟萃分析探讨了吸烟对这些骨折切开复位内固定（ORIF）术后SSI发生率的影响。
从PubMed、Embase和Cochrane数据库中获取关于吸烟对闭合性踝关节和跟骨骨折ORIF术后SSI发生率影响的全文研究，不考虑语言或出版日期。使用纽卡斯尔-渥太华量表评估研究质量。采用随机效应模型确定比值比（OR）及相应的95%置信区间（CI）。本荟萃分析遵循PRISMA指南，并在PROSPERO（CRD42023429372）注册。
该分析纳入了16项队列研究和病例对照研究的数据，共41944名受试者，其中9984名吸烟者，956例SSI病例。结果表明，吸烟者在ORIF术后面临更高的SSI风险（OR：1.62；95%CI：1.32 - 1.97，P < 0.0001），异质性较低（I² = 26%）。吸烟被确定为深部SSI的显著危险因素（OR：2.09；95%CI：1.42 - 3.09；P = 0.0002；I² = 31%）。然而，亚组分析显示吸烟与浅表SSI之间无关联（OR：1.05；95%CI：0.82 - 1.33；P = 0.70；I² = 0%）。
吸烟与闭合性踝关节和跟骨骨折ORIF术后SSI风险增加有关。虽然未发现浅表SSI与吸烟之间存在明确联系，但数据强调了吸烟对深部SSI发生率的负面影响。
