Assessment of Post-Operative Infection of Acetabular Fracture Fixation: Meta-Analysis

Background: Acetabular fractures is a break in the socket portion of the “ball and socket” hip joint. The operative treatment often necessitates extensive surgical exposure. Surgical site infection (SSI) an unfortunate and troublesome complication after surgery, usually leading to increased morbidity, mortality Objective: The aim of the current work was to investigate the risk factors of SSI after acetabular fracture surgery and to perform a meta-analysis of all the case-controlled trials (CCTs) to determine whether there were any significant differences in the average operation time, intraoperative blood loss, fracture end reset satisfaction rate, early/late complication rates, and the approach during operation and BMI. Patients and methods: This Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to investigate the risk factors of SSI after acetabular fracture surgery and to perform a meta-analysis of all the case-controlled trials (CCTs) in the last ten years to determine whether there were any significant differences in the average operation time, intraoperative blood loss, fracture end and the Harris hip score (HHS) good function rate. Results: Pooled prevalence of SSI was 6.71% among all studies and it was a significant rate like all studies as they were significant impacted rates in comparison to base (Zero). Majority among all studies were Staphylococcus species including Methicillin Resistant Staphylococcus aureus (MRSA), followed by Enterococcus faecalis. Operation time was significantly higher among cases of SSI at all studies and at pooled analysis. Regard pooled analysis diabetes mellitus (DM) considered as significant risk factor with Pooled OR 2.31 (1.1-8.63). Conclusion: The collected data from the included studies showed that operative time, injury severity score and DM are all risk factors after operation. Also, most common organism among all studies were Staphylococcus species including Methicillin Resistant Staphylococcus aureus (MRSA), followed by Enterococcus faecalis. Finally, in all studies we founded hypertension and smoking are not risk factors of the post-operative infection.

[1]  Legese Chelkeba,et al.  Incidence, risk factors and outcomes of surgical site infections among patients admitted to Jimma Medical Center, South West Ethiopia: Prospective cohort study , 2021, Annals of medicine and surgery.

[2]  L. Tompkins,et al.  Could the prevention of health care-associated infections increase hospital cost? The financial impact of health care-associated infections from a hospital management perspective. , 2020, American journal of infection control.

[3]  R. O’Toole,et al.  Risk Factors for Early Reoperation After Operative Treatment of Acetabular Fractures , 2018, Journal of orthopaedic trauma.

[4]  B. Frietman,et al.  Patient‐reported outcome measures after surgery for an acetabular fracture , 2018, The bone & joint journal.

[5]  J. Mwita,et al.  Prophylactic antibiotics to prevent surgical site infections in Botswana: findings and implications , 2018, Hospital practice.

[6]  Faizan Iqbal,et al.  Fucntional and Radiological Outcome of Surgical Management of Acetabular Fractures in Tertiary Care Hospital , 2016, Hip & pelvis.

[7]  Fahad A Almulhim,et al.  Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. , 2014, International surgery.

[8]  D. Zurakowski,et al.  Infirmity and Injury Complexity are Risk Factors for Surgical-site Infection after Operative Fracture Care , 2010, Clinical orthopaedics and related research.

[9]  D. Hak,et al.  Postoperative surgical site infection following acetabular fracture fixation. , 2010, Injury.

[10]  S. Kurtz,et al.  Infection burden for hip and knee arthroplasty in the United States. , 2008, The Journal of arthroplasty.

[11]  J JUDET,et al.  FRACTURES OF THE ACETABULUM: CLASSIFICATION AND SURGICAL APPROACHES FOR OPEN REDUCTION. PRELIMINARY REPORT. , 1964, The Journal of bone and joint surgery. American volume.

[12]  M. Rezaei,et al.  Risk factors for surgical site infections after open reduction and internal fixation of acetabulum fracture in the west of Iran , 2020 .

[13]  Ping Liu,et al.  Risk Factors of Surgical Site Infection after Acetabular Fracture Surgery. , 2015, Surgical infections.