Tracey Olivia C, Jones Ruth H, Adhiyaman Akshitha, Lijesen Emilie, Green Daniel W, McCarthy Moira M, Miller Andy O, Fabricant Peter D
Hospital for Special Surgery, New York, NY, USA.
Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
HSS J. 2025 Jun 26:15563316251347295. doi: 10.1177/15563316251347295.
Prior studies have suggested a possible association between eczema and postoperative surgical site infections (SSI) following anterior cruciate ligament reconstruction (ACL-R), presumably due to higher rates of staphylococcal colonization in patients with eczema. We sought to determine if patients with a history of eczema are at an increased risk for postoperative SSI following ACL-R, medial patellofemoral ligament reconstruction (MPFL-R), and/or knee arthroscopy. We conducted a retrospective matched case-control study of patients aged 5 to 25 years who underwent ACL-R, MPFL-R, and/or knee arthroscopy from February 1, 2016 to February 8, 2023 at a single tertiary care facility. Cases of postoperative infection were identified as those requiring surgical irrigation and debridement (I&D) and/or postoperative oral antibiotics or had a documented visit for postoperative infection with an infectious disease specialist within 6 months of the indexed procedure. Cases and controls were matched 1:2 based on sex, age ±1 year, body mass index ±1 kg/m, and primary Current Procedural Terminology code. Preoperative diagnosis of eczema and postoperative diagnosis of infection were compared between cases and controls. Three hundred patients were analyzed (mean age 18.2 ± 3.8 years); 4% of both cases and controls had a history of eczema. Patients with postoperative SSI did not have greater odds of having an eczema diagnosis preoperatively compared to matched controls. Overall, 32% of cases required an I&D procedure; these patients did not have greater odds of having an eczema diagnosis preoperatively compared to matched controls. This retrospective matched case-control study suggests that a prior or current diagnosis of eczema is not associated with SSI following ACL-R, MPFL-R, or knee arthroscopy in patients aged 5 to 25 years. Level III: Case-Control Study.
先前的研究表明,湿疹与前交叉韧带重建(ACL-R)术后手术部位感染(SSI)之间可能存在关联,推测原因是湿疹患者葡萄球菌定植率较高。我们试图确定有湿疹病史的患者在ACL-R、髌股内侧韧带重建(MPFL-R)和/或膝关节镜检查后发生术后SSI的风险是否增加。我们对2016年2月1日至2023年2月8日在一家三级医疗中心接受ACL-R、MPFL-R和/或膝关节镜检查的5至25岁患者进行了一项回顾性配对病例对照研究。术后感染病例被确定为那些需要手术冲洗和清创(I&D)和/或术后口服抗生素的患者,或者在索引手术6个月内有传染病专科医生记录的术后感染就诊记录的患者。病例和对照根据性别、年龄±1岁、体重指数±1kg/m²和主要当前手术操作术语代码进行1:2配对。比较病例组和对照组术前湿疹诊断和术后感染诊断情况。共分析了300例患者(平均年龄18.2±3.8岁);病例组和对照组均有4%的患者有湿疹病史。与配对对照组相比,术后发生SSI的患者术前被诊断为湿疹的几率并不更高。总体而言,32%的病例需要进行I&D手术;与配对对照组相比,这些患者术前被诊断为湿疹的几率并不更高。这项回顾性配对病例对照研究表明,在5至25岁的患者中,既往或当前诊断为湿疹与ACL-R、MPFL-R或膝关节镜检查后的SSI无关。三级:病例对照研究。