Analysis of incidence of postoperative wound infection in closed fractures treated by surgical fixation – A prospective study

BACKGROUND: In orthopaedic surgery where metallic implants are used, surgical site infection (SSI) is a significant complication as it increases the postoperative morbidity and mortality, prolongs hospital stay, and increases the hospital costs. Therefore, understanding the incidence of SSI in various healthcare settings would help us analyse the contributing factors and improve healthcare. Since the rates of SSI in various orthopaedic settings in India are lacking, this study aimed at analysing them and various associated factors in a tertiary medical institute in India. MATERIALS AND METHODS: This study was a prospective cohort study carried out on 100 orthopaedic patients who underwent surgical fixation for closed fractures, with a follow-up period of one year. The incidence of SSI and the factors associated with them were analysed. RESULTS: The overall incidence of SSI in our study was 5% (5 cases). The maximum incidence was seen in the age group 51–60 years (40% of the infections). Regarding the duration of preoperative hospital stay, the incidence of SSI was 6.85% when the patients stayed for more than 10 days, whereas the incidence was only 1.66% when the patients stayed for less than or equal to 10 days. Among the diabetics, the incidence of infection was found to be 7.69% (1 out of 13 diabetics). Regarding the operative duration, while cases which took more than 1.5 hours of operative duration had the highest infection rate (60% of the infections), none of the cases which took less than an hour to operate got infected. Among the infective organisms isolated, 60% cases had Staphylococcus aureus, 20% had Proteus vulgaris and another 20% had Klebsiella pneumoniae infection. CONCLUSIONS: Age greater than 50 years, a prolonged preoperative hospital stay more than 10 days, presence of diabetes, a prolonged surgical procedure more than 1.5 hours, and were found to be at a higher risk of SSI in our study.