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Identification of Risk Factors Contributing to the Development of Surgical Site Infection in Patients Undergoing Open Surgery for Closed Fractures of the Lower Extremity
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M Jafarzadeh    , M Falsafi , H Shirafkan , M Tavassoli * |
| 4.Clinical Research Development Center Unite of Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, I.R.Iran. , mehdi.tavasolii@gmail.com |
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Abstract: (373 Views) |
Background and Objective: Surgical site infection is one of the most prevalent and serious complications among patients undergoing surgical procedures. In orthopedic surgeries, wound infections are particularly noteworthy due to their higher incidence and clinical significance. The present study was therefore conducted to identify the risk factors contributing to the development of surgical site infection following surgical management of closed fractures of the lower extremity in patients presenting to Shahid Beheshti Hospital in Babol.
Methods: This cohort study was conducted on 133 patients who had sustained fractures of the lower extremity and had been admitted to Shahid Beheshti Hospital in Babol in 2021 and 2022. Postoperative follow-up for clinical signs of surgical site infection was performed at two intervals—2 weeks and 1 month following the procedure—and the results were systematically recorded. A comprehensive set of demographic and clinical variables was collected using a researcher-developed checklist, including age, sex, body mass index, underlying comorbidities, fracture location, length of stay, smoking status, type of surgical intervention, anesthetic technique, affected side, mechanism of injury, presence of infection, operative time (defined as time from skin incision to wound closure), and whether the procedure was performed on an emergency or elective basis.
Findings: Assessment of the overall incidence of surgical site infection following open surgery for closed lower extremity fractures, from the time of operation up to one month postoperatively, revealed that wound infection occurred in 32 patients (24.1%), representing a 24% incidence rate. At the two-week postoperative assessment, 12 patients (37.5%) demonstrated signs of infection, whereas at the one-month follow-up, 20 patients (62.5%) were found to have developed surgical site infection. Smoking status was significantly associated with the development of infection (p=0.005), and elective surgery was significantly correlated with the absence of infection (p<0.001). The mean length of hospital stay was significantly greater among patients who developed infection compared to those who did not (p<0.001). Prolonged operative time was also found to be significantly associated with infection (p=0.006). Multivariate regression analysis identified extended hospital stay and longer operative time as independent risk factors for the development of surgical site infection in patients with closed fractures.
Conclusion: The findings of the present study indicate that extended length of stay, prolonged operative time, and smoking are independent risk factors for the development of surgical site infection.
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Article number: e39 |
| Keywords: Infection, Closed Fracture, Lower Extremity, Risk Factor, Surgery. |
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Full-Text [PDF 654 kb]
(84 Downloads)
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Type of Study: Research |
Subject:
Orthopedics
Received: 2024/07/25 | Accepted: 2025/07/29 | Published: 2026/09/2
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