- 期刊
- OpenAccess
The fate of deep surgical site infection after osteosynthesis of pelvic and acetabular fractures
並列摘要
Purpose: The object of this study is to determine the incidence and outcomes of deep surgical site infectious after osteosynthesis of pelvic and acetabular fractures. Methods: We retrospectively reviewed the cases with pelvic and acetabular fractures underwent open osteosynthesis surgery from 2000 to 2009 in our institute. All the details of medical records and images were collected and analyzed. Patients with postoperative deep surgical site infection were enrolled in this study. Results: A total of 2,179 patients with closed pelvic and acetabular fractures underwent open osteosynthesis surgery during the study period. The overall incidence of surgical site infection was 1.3%. Twenty-two patients with pelvic and acetabular fracture cases with deep surgical site infection were enrolled in this study. The methicillin-resistance Staphylococcus aureus is the commonest micro-organism (68%) of infection. Twelve patients with SSI were identified as single bacterial infection whereas the rest of the patients were with mixed infections. All patients underwent staged debridement surgeries, ranging from 2 to 13 times. The implants were eventually removed in 4 patients with pelvic fractures, 2 with acetabular fractures and 2 with combined pelvic and acetabular fractures before the fracture being united. Antibiotic-loaded PMMA beads were implanted in 5 patients with pelvic fractures, 3 with acetabular fractures and 7 with combined fractures. The Majeed score was assessed at the 24-month follow-up and it revealed good result in 4 patients (18%), fair result in 8 patients (36%), and poor result in 8 patients (36%). Conclusions: The rate of infection after surgical osteosynthesis for the treatment of pelvic and acetabular fractures was relatively low. Once acute infection was suspected, staged surgical debridement was necessary. Implantation of antibiotic-loaded PMMA beads should be performed aggressively, especially for lesions involving the acetabulum. The functional outcome with surgical site infection in this specific group was unsatisfactory.
延伸閱讀
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