Noninfectious wound complications in clean surgery: epidemiology, risk factors, and association with antibiotic use.

Details

Serval ID
serval:BIB_FBA3C0A64281
Type
Article: article from journal or magazin.
Collection
Publications
Title
Noninfectious wound complications in clean surgery: epidemiology, risk factors, and association with antibiotic use.
Journal
World journal of surgery
Author(s)
Uçkay I., Agostinho A., Belaieff W., Toutous-Trellu L., Scherer-Pietramaggiori S., Andres A., Bernard L., Vuagnat H., Hoffmeyer P., Wyssa B.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
05/2011
Peer-reviewed
Oui
Volume
35
Number
5
Pages
973-980
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Noninfectious wound complications are frequent and often are confused with and treated as infection.
We assessed the epidemiology, impact, risk factors, and associations with antibiotic use of noninfectious wound complications in clean orthopedic and trauma surgery. We report a single-center, prospective, observational study in an orthopedic department.
Among 1,073 adult patients, 630 (59%) revealed clinically relevant postoperative noninfectious wound complications, leading to a significant prolongation of hospital stay (14 vs. 12 days; Wilcoxon rank-sum test; p<0.02) compared with patients without complications. The most frequent and severe complications were discharge with dehiscence (n=437; 41%) and hematoma (n=379; 35%). Forty-seven patients (47/630; 7%) underwent reoperation for dehiscence (n=39) or hematoma (n=8). These patients made up 4.3% of the entire study population (47/1,073). In multivariate analysis, an ASA score≥2 points, age≥60 years, surgery duration for ≥90 min, implant-related surgery, and poor compliance toward nurses' recommendations were pronounced risk factors for these complications, whereas antibiotic-related parameters had no influence. Staple use was significantly associated with wound discharge but not with hematoma.
Wound complications, such as dehiscence with discharge or hematoma after clean orthopedic and trauma surgery, are frequent with an overall incidence of 60%. Although they lead to few surgical reinterventions, they prolong hospital stay by 2 days. Few clinical parameters show association with wound complications. Among them, improvements of patient compliance and avoidance of staples use for skin closure are the most promising actions to decrease complication risk.

Keywords
Aged, Aged, 80 and over, Antibiotic Prophylaxis, Hematoma/surgery, Humans, Length of Stay, Middle Aged, Multivariate Analysis, Orthopedic Procedures, Prospective Studies, Surgical Wound Dehiscence/surgery, Wounds and Injuries/surgery
Pubmed
Web of science
Create date
16/01/2018 22:20
Last modification date
20/08/2019 16:26
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