Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture
Background Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic frac...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Critical Care Medicine
2022-05-01
|
| Series: | Acute and Critical Care |
| Subjects: | |
| Online Access: | http://www.accjournal.org/upload/pdf/acc-2021-01396.pdf |
| _version_ | 1811312300544491520 |
|---|---|
| author | Kang Min Kim Myoung Jun Kim Jae Sik Chung Ji Wool Ko Young Un Choi Hongjin Shim Ji Young Jang Keum Seok Bae Kwangmin Kim |
| author_facet | Kang Min Kim Myoung Jun Kim Jae Sik Chung Ji Wool Ko Young Un Choi Hongjin Shim Ji Young Jang Keum Seok Bae Kwangmin Kim |
| author_sort | Kang Min Kim |
| collection | DOAJ |
| description | Background Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients. Methods We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study. Results SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis. Conclusions Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study. |
| first_indexed | 2024-04-13T10:34:45Z |
| format | Article |
| id | doaj.art-7195430c89084296a71069ac7ad86e93 |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-04-13T10:34:45Z |
| publishDate | 2022-05-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-7195430c89084296a71069ac7ad86e932022-12-22T02:50:05ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602022-05-0137224725510.4266/acc.2021.013961368Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fractureKang Min Kim0Myoung Jun Kim1Jae Sik Chung2Ji Wool Ko3Young Un Choi4Hongjin Shim5Ji Young Jang6Keum Seok Bae7Kwangmin Kim8 Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Trauma Center, National Health Insurance Service Ilsan Hospital, Goyang, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, KoreaBackground Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients. Methods We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study. Results SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis. Conclusions Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study.http://www.accjournal.org/upload/pdf/acc-2021-01396.pdfbone fracturespelvic bonesurgical wound infection |
| spellingShingle | Kang Min Kim Myoung Jun Kim Jae Sik Chung Ji Wool Ko Young Un Choi Hongjin Shim Ji Young Jang Keum Seok Bae Kwangmin Kim Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture Acute and Critical Care bone fractures pelvic bone surgical wound infection |
| title | Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| title_full | Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| title_fullStr | Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| title_full_unstemmed | Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| title_short | Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| title_sort | determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture |
| topic | bone fractures pelvic bone surgical wound infection |
| url | http://www.accjournal.org/upload/pdf/acc-2021-01396.pdf |
| work_keys_str_mv | AT kangminkim determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT myoungjunkim determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT jaesikchung determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT jiwoolko determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT youngunchoi determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT hongjinshim determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT jiyoungjang determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT keumseokbae determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture AT kwangminkim determinationofriskfactorsassociatedwithsurgicalsiteinfectioninpatientsundergoingpreperitonealpelvicpackingforunstablepelvicfracture |