بررسي شيوع عفونت بعد از اعمال جراحي فيكساسيون شكستگي در بيماران بستري در بخش ارتوپدي بيمارستان رازي اهواز طي سالهاي 1384-1383

Assessment of prevalence of infection following fracture fixation operation among patients admitted to orthopedics ward of Ahwaz Razi hospital during year 1383 to 1384

Objective: Advancements in fixation devices and techniques in orthopedic surgery during the recent decades have brought about an increase in operative indications of fracture fixation. However, in spite of these advances the rate of infection ranges between 0.8 to 1.2% for Total Hip Arthoplasty (T.H.A), 3.6 to 8.1% for closed fractures and 17.5-21.2% for open fractures. The aim of the present study was to evaluate the prevalence and correlate the factors affecting the development of infection among orthopedic patients requiring fracture fixations in our centre. Subjects and Methods: This study was carried out during the period of 1383-1384 in orthopedics ward of Ahwaz Razi Hospital. All patients who were admitted due to upper and lower extremity fractures and had undergone fracture fixation operations were included in this study. The patients were followed up and assessed for clinical and laboratory findings of infection. A specimen from deep tissues were taken for microbial testing and personal data regarding age, sex and predisposing factors were recorded in a questionnaire. Results: During the period of this study, 1573 patients had undergone fracture fixation which including 1239 (78.8 %) men and 334 (21.3%) women. There were 1349 closed fracture (85.8%) and 224 open fractures (14.2%). Overall 60 patients (3.7%) showed clinical and laboratory findings of wound infection. In 56 cases the fractures were in lower extremity and 4 in the upper extremity. Infection rate in closed fractures was 1.55% vs 17.41% for open fractures, the rate of infection increased with severity of fracture type I to lIlc. The most common recovered microorganisms were Pseudomoras (23.3%), Klebsiella (21.6%) and Staphylococcu aureus (11.6%). Twenty five % of patients were smoker (>= 10 cigarettes/day), 8.6% had UTI and 6.6% had history of diabetes. Conclusion: The rate of infection in closed fractures in this study corresponds to universal data. However, infection rate in open fractures and especially type II & III (a,b,c) was higher than expected. Among the predisposing factors are smoking more than or equal to 10 cigarettes/day.