Analysis of risk factors related to postoperative incision infection for closed tibial fractures with internal fixation
WANG Bin1 ZHANG Wenxian2 LIAO Minjie2 ZHANG Kun2 SU Qi3 LI Jialin3 YAN Qikai3 ZHAO Jianwei3
1.Department of Orthopedics, Yushan Huangjiasi Hospital (Yushan People’s Hospital), Jiangxi Province, Yushan, 334700, China;
2.the First Department of Traumatic Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Gansu Province, Lanzhou 730050, China;
3.Graduate School, Gansu University of Chinese Medicine, Gansu Province, Lanzhou 730030, China
Abstract：Objective To analyze and discuss the possible influencing factors of postoperative incision infection for closed tibial fracture, and to provide some scientific theoretical basis for clinical prevention and treatment of postoperative incision infection for closed tibial fracture. Methods The data of 397 patients with closed tibial fractures treated by surgical internal fixation and followed up in the Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2018 to October 2019 were retrospectively analyzed by using the hospital electronic medical record system. Single-factor and multi-factor statistical analysis were performed on patients’ data. Results A total of 397 patients were followed up for six to twelve months, including ten patients with postoperative incision infection. Age ≥60 years old, hospitalization days ≥two weeks, body mass index ≥28 kg/m2 , combined with basic diseases (diabetes mellitus, hypertension, hyperlipidemia), smoking, duration of surgery ≥two hours, general anesthesia, intraoperative blood loss ≥500 mL, not reasonable use of antibiotics, not using negative pressure drainage, the higher soft tissue injury classification, the closed tibial fracture internal fixation of postoperative incision infection rate increased, the differences were statistically significant (all P < 0.05). Among them, age≥60 years old (OR = 4.136, 95%CI: 1.144-14.951, P ＜ 0.05), obesity (OR = 4.949, 95%CI: 1.258-19.461, P < 0.05), combined diabetes mellitus (OR = 5.250, 95%CI: 1.449-19.027, P ＜ 0.05), duration of surgery ≥two hours (OR = 5.714, 95%CI: 1.398-23.357, P ＜ 0.05) were independent risk factors for postoperative incision infection, while rational use of antibiotics (OR = 0.128, 95%CI: 0.025-0.668, P ＜ 0.05) and using negative pressure drainage (OR = 0.184, 95%CI: 0.039-0.877, P ＜ 0.05) during the whole perioperative period were independent protective factors for postoperative incision infection. Conclusion Postoperative incision infection is related to many factors in the whole perioperative period. Enough attention should be paid to in clinical work and positive prevention measures should be taken accordingly to reduce the postoperative incision infection rate of closed tibial fracture and finally achieve the goal of health medicine.
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