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Abstract
Background: In spite of decreasing incidence of orthopedic device-related infections to 1%, nowadays, devicerelated infection still remains a diagnostic, therapeutic and cost-related problem. The objective of this study is to evaluate the contributing risk factors for orthopedic device-related infections in Sina Hospital, Tehran, Iran.
Methods: Three hundred and thirty patients who underwent orthopedic device implantation from 2002-2006 were enrolled; among them, 110 patients were complicated with infection. Descriptive and logistic regression analyses were performed to determine the risk factors for device related infections.
Results: Patients with infection were older compared to those without infection. The Staphylococcus aureus was the commonest organism. A correlation was observed between wound infection and external fixation, an underlying health condition, and addiction which were independent risk factors for a device related infection.
Conclusion: Orthopedic device-related infection puts a great financial burden on patients and hospital resources and could lead to morbidity and mortality in patients. So, appropriate pre and postoperative wound care for dirty wounds, especially when external fixators are used, and in patients with poor conditions or addiction should be done with more caution.
Keywords: Orthopedic devices; Infection; Implant surgery; Microorganisms
Introduction
The number of elderly and trauma patients requiring joint replacement or fixation devices is steadily increasing. The risk of infectious complications associated with orthopedic devices has been decreased during the past 2 decades, with development of sophisticated preventive strategies. Infections associated with prosthetic joints occur less frequently than aseptic failures, but they represent the most devastating complications with high morbidity and substantial costs.1 Overall, about 5% of the internal fixation devices become infected.2 The incidence of infection after the internal fixation of closed fractures is generally lower (0.5-2%), whereas the incidence may exceed 30% after the fixation of open fractures.3-5
It is expected that the incidence of orthopedic device- related infections (ODRIs) and the absolute number of patients with such infections will further increase due to better detection methods, the growing number of implanted prostheses in the aging population, and the increasing residency time of prostheses, which are at a continuous risk of infection during their implanted lifetime.6 Furthermore, due to the scarcity of infections per institution, randomized controlled clinical trials are hampered and the treatment of such infections is poorly standardized. Therefore, ODRI...
