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· DOS Abstracts
A review of deep wound infection after hip-fracture
surgery
Frederik Stensbirk, Henrik Palm
Orthopaedic Surgery, Copenhagen University Hospital Hvidovre
Background:
Deep wound infection is one the most severe and costly compli-
cations following hip-fracture surgery. The few previously published series have
shown multiple re- operations, longer hospitalization, massive antibiotic treat-
ment and increased mortality and morbidity. For improving results, surgeons
should besides performing surgical debridement be aware, which organisms are
responsible, the relevant antibiotics, and the consequences for patient and hos-
pital.
Purpose / Aim of Study:
To investigate rate, bacteriology and antibiotic treat-
ment of patients developing deep wound infection following hip-fracture sur-
gery.
Materials and Methods:
4189 consecutive hip fracture patients admitted
and treated at our hospital from September 2002 to June 2013 were included.
All patients were treated with arthroplasty, intramedullary nailing, dynamic hip
screw or parallel screws/pins. Retrospectively, deep wound infections, bacteri-
ology, antibiotic treatment, hospitalization, number of re-operations and 1-year
mortality were investigated.
Findings / Results:
73 patients reoperated due to deep wound infection were
identified (1.7%). 80 positive bacterial cultures were identified. 45 displayed
S. aureus (63%), 13 coag. neg. staph. (18%), 7 E. coli (10%), 15 distributed
on 10 other bacteria, while 6 patients had negative bacteria cultures (8%). 17
cultures were resistant to cefuroxime (21%). 29 patients were treated with >3
antibiotics (40%). Hospitalization was 52 days. 37 patients were re-operated
more than once (51%). Within the first year after re- operation 30 patients had
died (41%).
Conclusions:
A deep wound infection rate at 1.7% is relatively low and compa-
rable to previously published series, but when it occurs, consequences are dev-
astating. Continuous focus on infection registration and optimal prophylactics
and treatment is therefore important to improve outcome.
95.
