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RESEARCH ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 4  |  Page : 132-137

Surgical site infections in orthopedic surgery: incidence and risk factors at an Iranian teaching hospital


1 Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Iran University of Medical Sciences, Tehran, Iran
3 Azad University of Medical Sciences, Tehran, Iran

Correspondence Address:
Mahtab Rahbar
Iran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2542-4157.219372

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Background and objectives: Surgical site infection (SSI) is rare complication in orthopedic surgery and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, body mass index (BMI), prophylactic antibiotics, operation technique and duration, type of shaving, and length of hospitalization. This study aimed to determine the risk factors affecting orthopedic surgical site infections and their incidence at Imam Reza and Taleghani , two major referral teaching hospitals in west of Iran. Design: A prospective cohort study. Methods: A 36-month prospective cohort study, with 1 to 12 months of patient follow-up after surgery, was conducted at the teaching hospital in Iran. Patients (n = 1,900) who had undergone orthopedic surgery were studied between January 2012 and January 2015. Each patient was followed by pre- and post-operative examinations and telephone follow-ups. Results: Of the 1,900 patients, 73 suffered from SSI (3.84%). Methicillin Resistant Staphylococcus aureus (MRSA) 53% (n = 25) and Staphylococcus coagulase-negative 32% (n = 15) are the most common isolated germs. The smoking, high BMI, multiple fractures, increased operation time, increased bed stay, electivity of the operation, type of operation, using prosthetic implant and pre-operation of prophylactic antibiotic were all significantly associated with increased evidence of SSI (P < 0.04). Conclusion: Our study presented that stopping smoking, appropriate pre- and post-operational antibiotic prophylaxis regimens specially when using prosthetic implant, shortening duration of surgery and hospitalization and experience of the surgeon should be helpful to reduce rate of SSI.


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