Risk Factors for Wound Complications in Patients After Elective Orthopedic Foot and Ankle Surgery

NewsBot · Jan 1, 2015

Members do not see these Ads. Sign Up.
Risk Factors for Wound Complications in Patients After Elective Orthopedic Foot and Ankle Surgery.
Wiewiorski M, Barg A, Hoerterer H, Voellmy T, Henninger HB, Valderrabano V.
Foot Ankle Int. 2014 Dec 30. pii: 1071100714565792.

BACKGROUND:
The aim of this study was to quantify the incidence of postoperative wound complications in elective foot and ankle surgery as well as the risk factors for postoperative wound complications.
METHODS:
Two hundred ninety-five elective orthopaedic foot and ankle operative procedures were performed in 290 patients between January 2006 and June 2010. A logistic multiple regression model was used to identify independent risk factors for postoperative wound healing complications/infection.
RESULTS:
The overall prevalence of postoperative wound complications within our cohort was 16.9%. In 4 patients (1.4%) deep infection was diagnosed requiring operative irrigation and debridement. Using a logistic multiple regression model we identified the following statistically independent risk factors: age ≥ 60 years (OR = 8.98, 95% CI = 3.55 to 25.02), tobacco use (OR = 48.77, 95% CI = 15.55 to 139.71), and tourniquet time ≥ 90 minutes (OR = 7.02, 95% CI = 2.77 to 19.32).
CONCLUSION:
Patients at risk for postoperative wound healing complications following elective orthopaedic foot and ankle surgery include those with higher age, tobacco use, and prolonged use of tourniquet.
Click to expand...

Admin2 · Jan 1, 2015

Related Threads:
Incidence and Risk Factors for Venous Thromboembolic Disease in Foot Surgery
Forefoot Surgery in Elderly Compared With Younger Patient Populations
Clinical negligence in foot and ankle surgery
Factors associated with chronic pain one year after foot surgery
Pain Management for Elective Foot and Ankle Surgery
Impact of Podiatry Resident Experience Level in Hallux Valgus Surgery on Postoperative Outcomes
Changes in Mood State after Day Case Forefoot Surgery
Postoperative Immobilization in Foot and Ankle Surgery
Factors associated with patient satisfaction with foot and ankle surgery

NewsBot · May 13, 2015

Topically Applied Vancomycin Powder Reduces the Rate of Surgical Site Infection in Diabetic Patients Undergoing Foot and Ankle Surgery
Dane K. Wukich, MD Jeffrey W. Dikis, DPM; Spencer J. Monaco, DPM; Kristin Strannigan, DPM; Natalie C. Suder, MPH; Bedda L. Rosario, PhD
Foot & Ankle International May 12, 2015

Background: The purpose of this study was to evaluate the efficacy of topically applied vancomycin powder in reducing the rate of surgical site infections (SSIs) in patients with diabetes mellitus (DM) undergoing foot and ankle surgery.
Methods: Eighty-one patients with DM who underwent reconstructive surgery of a foot and/or ankle deformity and/or trauma and who received topically applied vancomycin were matched to 81 patients with DM who did not receive topically applied vancomycin. The mean age was 60.6 years in the vancomycin group and 59.4 years in the control group (P < .05). The 2 groups were similar with regard to gender, body mass index, duration of DM, short-term and longer term glycemic control, and length of surgery.
Results: The overall likelihood of SSI was decreased by 73% in patients who received topically applied vancomycin (odds ratio [OR], 0.267; 95% CI, 0.089-0.803; P = .0188). The rate of superficial infection was not significantly different between the 2 groups (OR, 0.400; 95% CI, 0.078-2.062; P = .2734); however, deep infections were 80% less likely in patients who received vancomycin powder (OR, 0.200; 95% CI, 0.044-0.913; P = .0377).
Conclusion: High-risk diabetic patients undergoing foot and ankle surgery were notably less likely to develop an SSI with the use of topically applied vancomycin powder in the surgical wound, particularly with regard to deep infections. Topically applied vancomycin was associated with a very low rate of complications and was inexpensive ($5 per 1000 mg). Based on this study, foot and ankle surgeons may consider applying 500 to 1000 mg of vancomycin powder prior to skin closure in diabetic patients who are not allergic to vancomycin.
Click to expand...

NewsBot · Jul 18, 2024

What Is the Risk of Irrigation and Debridement Following Foot and Ankle Surgery? Development of a Risk Severity Scoring System
Lisa Bonsignore-Opp et al
Clin Orthop Relat Res. 2024 Jul 15

Background: Surgical site infection (SSI) after foot and ankle surgery has serious negative effects on patient health and quality of life. While previous studies have looked at predisposing factors for SSI, to our knowledge, no study has proposed a risk severity score.

Questions/purposes: Can a risk severity score, based on patient demographic characteristics and surgical variables, be developed for preoperative use in patients undergoing foot and ankle surgery that will calculate the risk of an irrigation and debridement (I&D) procedure within 90 days of surgery utilizing data from previous surgeries?

Methods: A retrospective chart study was performed on patients undergoing foot and ankle surgery. Data on demographic characteristics including age, sex, and BMI were recorded. Data on patient factors including diabetes and smoking history were also recorded. Surgical details including length of surgery, procedure type, surgeon, antibiotic delivery time, antibiotic type, and antibiotic dose were analyzed. Of 2979 procedures, 1% (36) of I&Ds were performed within 90 days. The mean age at surgery was 49 ± 17 years, and 57% (1702) of patients were female. The mean BMI was 28 ± 6 kg/m2. The primary outcome was I&D within 90 days postoperatively. Descriptive statistics of differences in patient characteristics between those who underwent I&D and those who did not were examined using chi-square tests and t-tests (p < 0.05 was taken as significant). Significant variables from a simple regression analysis were included in a multiple logistic regression model with a forward stepwise procedure for variable selection. We required all data in the model to be categorical; thus, continuous variables such as time were dichotomized. We factored odds ratios determined by multiple regression for significant variables into the final risk severity score, and an easy-to-use tool based on this risk severity score was created in Excel (Microsoft).

Results: Current tobacco use, diabetes, and longer operative times were the only factors associated with I&D within 90 days postoperatively. A risk severity score was developed using current tobacco use, diabetes, and length of surgery greater than 60 minutes as factors. A patient with a severity score of 0 (no risk factors) had a 0.6% chance of I&D within 90 days, while a severity score of 1 indicated a 1.1% chance, a score of 2 indicated a 2.1% chance, a score of 3 indicated a 4.0% chance, and a score of 4 (all risk factors) indicated a 7.5% chance of I&D within 90 days. A spreadsheet that can be used at the point of care was created based on these findings.

Conclusion: Our risk severity score may help inform preoperative patient guidance and operative planning. Calculating the score in the office setting during preoperative visits can also improve communication between physician and patient. Future research should focus on validation of this risk severity score at multiple institutions.
Click to expand...

NewsBot · Oct 10, 2024

Incidence and associated factors of surgical site infection in patients undergoing foot and ankle surgery: a 7-year cohort study
João Murilo Magalhães et al
The Foot, Volume 59, June 2024, 102092

Highlights
•Surgical site infection is the main cause of postoperative readmission.
•Surgical site infection increases the length of hospital stay, increases the cost of treatment, increases comorbidities and delays rehabilitation.
•Knowing the risk factors that increase the chance of post-operative infection can help to prevent it.
•Smoking, urgent surgical procedure and ASA > 2 are risk factors for surgical site infection.
Click to expand...

Surgical site infections (SSI) constitute 31% of all hospital-acquired conditions, with ankle and foot surgical procedures showing an incidence of SSI ranging from 0.5% to 6.5%. This study aimed to assess the incidence of both superficial and deep surgical site infections in foot and ankle surgery, along with associated factors. Conducted as a retrospective cohort study, it included 2180 patients undergoing foot and ankle surgery in a private hospital between 2014 and 2020, encompassing elective and trauma cases. Outcome variables comprised SSI, while predictor variables encompassed sex, age, diabetes mellitus, systemic arterial hypertension, smoking, American Society of Anesthesiologists (ASA) score, and body mass index. Logistic regression models were employed to identify associations between study variables. The incidence of surgical site infections stood at 4% (83/2180), comprising a rate of 2.8% (57/2180) for superficial infections and 1.2% (26/2180) for deep infections. Smoking (OR 2.9, 95%CI 1.4–5.3) and ASA score >2 (OR 3.4, 95%CI 1.2–8.4) emerged as independent factors associated with surgical site infections. The group with deep infections exhibited higher proportions of smokers (p = 0.002), systemic arterial hypertension (p = 0.018), trauma surgery (p = 0.049), and an ASA score >2 (p = 0.011). Overall infection incidence in this cohort reached 4%, with trauma cases, smoking, hypertension, and an ASA score >2 independently linked to deep infections. Surgeons should be cognizant of these risk factors when managing prophylactic antibiotic regimens for patients.
Click to expand...

Risk Factors for Wound Complications in Patients After Elective Orthopedic Foot and Ankle Surgery

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Chronic diseases and allergies as risk factors for MTSS

Risk factors for ingrown toenails

Incidence and Risk Factors for Pin Site Infection of Exposed Kirschner Wires

The risk factors for diabetic peripheral neuropathy

Incidence and Risk Factors for Foot Fractures

Genetic risk factors for plantar fasciitis

Genetic risk factors for an ankle sprain

Share This Page

Risk Factors for Wound Complications in Patients After Elective Orthopedic Foot and Ankle Surgery

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Chronic diseases and allergies as risk factors for MTSS

Risk factors for ingrown toenails

Incidence and Risk Factors for Pin Site Infection of Exposed Kirschner Wires

The risk factors for diabetic peripheral neuropathy

Incidence and Risk Factors for Foot Fractures

Genetic risk factors for plantar fasciitis

Genetic risk factors for an ankle sprain

Share This Page

Useful Searches