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. 2024 Dec 25:15589447241305422.
doi: 10.1177/15589447241305422. Online ahead of print.

Effect of Time to Surgery on Surgical Site Infection in Open Distal Radius Fractures: A Review of the ACS Trauma Quality Improvement Program Database

Walter Sobba  1 , Lawrence J Lin  1 , Gerardo E Sanchez-Navarro  1 , Jadie De Tolla  1 , Omri Ayalon  1 , Jacques H Hacquebord  1
Affiliations

Effect of Time to Surgery on Surgical Site Infection in Open Distal Radius Fractures: A Review of the ACS Trauma Quality Improvement Program Database

Walter Sobba et al. Hand (N Y). .

Abstract

Introduction: Managing open distal radius fractures (DRFs) poses challenges. While preventing surgical site infection (SSI) involves prompt antibiotic administration and thorough irrigation and debridement, the impact of urgent intervention on reducing postoperative infection rates is debated. We hypothesize that timing of surgery does not significantly affect the incidence of SSI in open DRF treated within or after 24 hours from time of injury.

Methods: We retrospectively analyzed the American College of Surgeons Trauma Quality Improvement Program from 2011 to 2021. We focused on outcome variables, including superficial SSI and deep SSI or osteomyelitis. To evaluate the relationship between time to operative intervention and SSI rates, we employed least absolute shrinkage and selection operator and multivariate regression models, adjusting for patient-specific factors and injury severity.

Results: A total of 14 486 patients were included. Regression modeling demonstrated a 23% increase in the odds of deep SSI with each 1-day delay in surgery (P = .010). However, no association was found between time to surgery and superficial SSI (odds ratio [OR] = 0.96, P = .768). Injury severity score (ISS) was associated with increased odds of superficial SSI (OR = 1.06, P < .001) and deep SSI (OR = 1.06, P < .001) while diabetes (OR = 3.56, P = .013) was significantly associated with increased rates of superficial SSI.

Conclusions: Extended time to surgery correlates with a modest rise in deep SSI incidence in open DRF. However, there was no heightened risk of superficial SSI in patients with delayed surgery. Polytrauma, alcohol use disorder, and diabetes were linked to elevated SSI rates in open DRF.

Keywords: ACS-TQIP; open distal radius fracture; surgical site infection; time to surgery; trauma.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

    1. Iorio ML, Harper CM, Rozental TD. Open distal radius fractures: timing and strategies for surgical management. Hand Clin. 2018;34(1):33-40. doi:10.1016/j.hcl.2017.09.004 - DOI - PubMed
    1. Ketonis C, Dwyer J, Ilyas AM. Timing of debridement and infection rates in open fractures of the hand: a systematic review. Hand. 2017;12(2):119-126. doi:10.1177/1558944716643294 - DOI - PMC - PubMed
    1. Rozental TD, Beredjiklian PK, Steinberg DR, et al. Open fractures of the distal radius. J Hand Surg Am. 2002;27(1):77-85. doi:10.1053/jhsu.2002.30073 - DOI - PubMed
    1. Lancaster P, Eves T, Tennent D, et al. Open fractures of the upper limb—do the BOAST guidelines need an update? Injury. Published online April 15, 2023. doi:10.1016/j.injury.2023.04.029 - DOI - PubMed
    1. Bano C, Coffey D, Al-Tawil K, et al. Management of open elbow fractures: experiences and outcomes from a UK major trauma center. J Shoulder Elbow Surg. 2022;31(3):461-468. doi:10.1016/j.jse.2021.10.029 - DOI - PubMed

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