Journal of orthopaedic trauma · 2022
Are Infection Rates Increased After Sterilization of the External Fixator During Staged Internal Fixation of High-Energy Tibial Plateau Fractures?
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Moon Tyler James, Haase Lucas, Haase Douglas, Ochenjele George, Wise Brent, Napora Joshua
Аннотация
OBJECTIVES: To compare infection rates after second-stage definitive surgery for high-energy tibial plateau fractures between groups of patients who had the external fixator prepped into the surgical field and those who did not.
DESIGN: Retrospective cohort study.
SETTING: Two academic Level 1 trauma centers.
PATIENTS/PARTICIPANTS: Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions.
INTERVENTION: Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the prepped group, and 82 patients were in the nonprepped group.
MAIN OUTCOME MEASUREMENTS: The primary outcome was the rate of deep infection after definitive fixation. Secondary outcome was operative time.
RESULTS: There were no significant differences in infection rates between prepped (11.7%) and nonprepped (18.3%) groups ( P = 0.162). Patients in the prepped groups had significantly decreased operative time (168.2 minutes vs. 221.9 minutes, P < 0.001) even after controlling for confounders in regression analysis.
CONCLUSIONS: There is no increased risk of infection associated with prepping and maintenance of the external fixator during definitive internal fixation for high-energy tibial plateau fractures. These data suggest that this practice may lead to shorter operative times as well.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
DESIGN: Retrospective cohort study.
SETTING: Two academic Level 1 trauma centers.
PATIENTS/PARTICIPANTS: Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions.
INTERVENTION: Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the prepped group, and 82 patients were in the nonprepped group.
MAIN OUTCOME MEASUREMENTS: The primary outcome was the rate of deep infection after definitive fixation. Secondary outcome was operative time.
RESULTS: There were no significant differences in infection rates between prepped (11.7%) and nonprepped (18.3%) groups ( P = 0.162). Patients in the prepped groups had significantly decreased operative time (168.2 minutes vs. 221.9 minutes, P < 0.001) even after controlling for confounders in regression analysis.
CONCLUSIONS: There is no increased risk of infection associated with prepping and maintenance of the external fixator during definitive internal fixation for high-energy tibial plateau fractures. These data suggest that this practice may lead to shorter operative times as well.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.