Surveillance of surgical site infections in orthopedic prosthetic surgery: a tool for identifying risk factors and improving clinical practice

J Prev Med Hyg. 2024 Aug 31;65(2):E273-E277. doi: 10.15167/2421-4248/jpmh2024.65.2.3141. eCollection 2024 Jun.

Abstract

Introduction: Surgical site infections (SSIs) are among the most frequently encountered complications in prosthetic surgery, and are associated with increased hospitalization, costs and in-hospital mortality. There is no national system for the comprehensive monitoring of the incidence of SSIs.

Methods: All patients undergoing orthopedic prosthetic surgery from April 1 to June 30, 2023 were enrolled. Clinical evaluation of the surgical site was conducted at 30 days, and a follow-up telephone interview was carried out by means of a specially designed questionnaire at 90 days.

Results: A total of 59 patients were included. Surgery was performed on the knee in 71.19% and on the hip in 28.81%. The patients' mean BMI was 28.25 ± 2.97, and their mean ASA score was 2.67 ± 0.58. Six patients had diabetes mellitus. The incidence of SSIs was 5.08%; two infections occurred in knee prosthesis surgery and one in hip surgery. Analysis of the data revealed that diabetes was the main risk factor for the development of infection.

Conclusions: Although based on a small number of patients, these results are encouraging, especially considering that the patients had an average ASA score of more than 2 and a high BMI. However, to further reduce the risk of infection, improved hygiene measures have now been implemented in the operating room and the antibiotic prophylaxis protocol has been updated to take into account the potential for MRSA colonization.

Keywords: Antimicrobial prophylaxis; Knee and Hip prosthesis; Surgical Site Infection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Knee / adverse effects
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Risk Factors
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control