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Analysis of the incidence of surgical site infections after open reposition of long bone fractures and closed fracture settings in a 7-year follow-up in an orthopedic and trauma ward in southern Poland.

INTRODUCTION
Surgical Site Infection (SSI) is the most common clinical form of Healthcare-Associated Infections (HAI) in orthopedic and trauma wards.


MATERIAL AND METHOD
A retrospective study was conducted at the Department of Orthopedics and Trauma Surgery in Tarnów in 2012-2018. 3 155 patients treated for bone fractures were analyzed, including 1961 Open Reduction of Fracture (FX) and 1 194 Closed Reduction of Fracture with Internal Fixation (CR) surgeries. The study was conducted in accordance with the methodology recommended by the Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). The aim of the study was to assess the incidence of SSI in patients undergoing the FX and CR procedures.


RESULTS
28 SSIs were identified in the examined ward; 16 SSI cases related to the FX procedure and 12 cases related to CR. The incidence for FX was 0.8% and for CR 1%. In patients with diagnosed SSI, the stay in the ward was longer (p <0.001) than in patients without SSI. In FX operations, the standardized risk index (SIR) did not exceed the value of one. Staphylococcus aureus was the most common organism isolated from materials from patients with SSI.


CONCLUSIONS
In the examined period, the median age of women was higher than that of men, which may indicate a higher incidence of fractures in women. Patients with diagnosed SSI had a longer stay in the ward than patients without SSI. The incidence of SSI in FX and CR has been reduced compared to previous studies in the same ward.