: Surgical site infections (SSIs) are the most common healthcare-associated infections (HAIs) in surgical wards. The highest risk of developing SSI is carried by operations involving implants, such as: hip prosthesis (HPRO), knee prosthesis (KPRO), open reduction of fracture (FX), and closed reduction of fracture with internal fixation (CR). Objectives. The objective of the study was to assess the incidence of SSI in patients subjected to HPRO, KPRO, FX, and CR procedures in orthopaedics and trauma wards in 2014-2018 considering risk factors included in the SIR index. : The study included 6261 patients who were subjected to orthopaedic surgery in 2014-2018. The investigation covered three hospitals with orthopaedics and trauma wards. The research was conducted in the framework of the national HAI surveillance programme according to the methodology of the HAI-Net, ECDC. : A total of 6261 surgeries were investigated, of which 111 cases of SSI were detected. The incidence was 1.8%; HPRO (incidence 2.1%, median (Me) surgery duration 90 min, and standardized infection ratio (SIR) above 1 in all units tested); KPRO (incidence 2.0%, Me 103 min, and SIR above 1 for all units tested); FX (incidence 1.9%, Me 70 min, and SIR above 1 for two units tested and below 1 in one unit); CR (incidence 1.0%, Me 55 min, and SIR-not calculated). The etiological agents that were most frequently isolated from patients with SSI were Staphylococcus aureus, coagulase-negative Staphylococcus, and Klebsiella pneumoniae. : HPRO, KPRO, and FX operations performed in the studied wards carried a higher risk of developing SSI than that predicted by SIR. SSIs accounted for a significant percentage of the overall infection pool in CR surgeries. Actions should be undertaken to reduce the incidence of SSI in these surgeries. There should be a hospital network which facilitates cooperation in order to better monitor and analyse the incidence of SSI.
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http://dx.doi.org/10.3390/medicina58050682 | DOI Listing |
JOR Spine
March 2025
Department of Trauma Surgery, Orthopaedics and Plastic Surgery University Medical Center Göttingen Göttingen Germany.
Background: Unilateral sacral fractures with posterior ring instability represent a prevalent type of posterior pelvic ring fracture. While lumbo-pelvic fixation is recognized as a highly stable method, the sufficiency of unilateral lumbo-pelvic fixation (ULF) for such fractures remains under debate.
Purpose: This study aims to assess the biomechanical stability of ULF compared to traditional bilateral lumbo-pelvic fixation (BLF) and triangular osteosynthesis (TO), incorporating clinical observations, and previous biomechanical data.
Front Med (Lausanne)
January 2025
Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Background: Various factors contribute to postoperative delirium (POD) in elderly patients undergoing hip fracture surgeries. Sarcopenia was defined as the progressive loss of skeletal muscle mass and strength associated with aging. The aim of this study was to explore the prevalence of POD and sarcopenia in geriatric patients undergoing hip fracture surgeries and to investigate the correlation between preoperative sarcopenia and POD.
View Article and Find Full Text PDFCureus
December 2024
Department of Trauma and Orthopaedics, Barts Health NHS Trust, London, GBR.
A significant percentage of patients with retinopathy of prematurity (ROP) who progressed to stages 4 and 5 of ROP will require surgical intervention. Scleral buckling surgery is widely employed for the restoration of retinal detachment in advanced cases of ROP. This systematic review and meta-analysis aim to review the anatomical and visual outcomes following scleral buckling surgery in ROP of stages 4 and 5.
View Article and Find Full Text PDFCureus
December 2024
Orthopaedics, The Royal Wolverhampton National Health Service (NHS) Trust, Wolverhampton, GBR.
Background: Tranexamic acid (TXA) is a pharmacological agent used in reducing blood loss during orthopaedic surgeries, including total knee arthroplasty (TKA). Despite its proven efficacy and National Institute for Health and Care Excellence (NICE) guidelines recommending combined topical and intravenous administration, compliance in clinical practice often lags.
Objective: This study aimed to evaluate and improve adherence to NICE guidelines for TXA use during TKA through a quality improvement initiative.
Eur J Trauma Emerg Surg
January 2025
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Purpose: If surgery is indicated for elderly patients suffering a proximal humerus fracture, reverse fracture arthroplasty became the preferred type of treatment due to its good and reliable outcomes over the last decade. Surgeons could choose from a wide range of implants and up to now there was no evaluation, if a change of the manufacturer affects patients` outcome.
Methods: The last 100 patients before and the first 100 after manufacturer change in reverse fracture arthroplasty were evaluated at a level one trauma center, all treated by only 3 senior shoulder surgeons.
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