Surgical Wound Classification and Surgical Site Infections in the Orthopaedic Patient.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 30211353.
- Also identified by DOI 10.5435/JAAOSGlobal-D-17-00022 and PMC identifier 6132296.
- Licence recorded as CC BY-NC-ND.
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Abstract
The Centers for Disease Control and Prevention created a surgical wound classification system (SWC: I, clean; II, clean/contaminated; III, contaminated; and IV, dirty) to preemptively identify patients at risk of surgical site infection (SSI). The validity of this system is yet to be demonstrated in orthopaedic surgery. We hypothesize a poor association between the SWC and the rate of subsequent SSI in orthopaedic trauma cases. Nine hundred fifty-six orthopaedic cases were reviewed. Wounds were risk stratified intraoperatively using the SWC grades (I-IV). SSI was diagnosed clinically or with objective markers. The SWC was compared with SSI rates using a Fisher exact test. Significance was set at <i>P</i> < 0.05. Four hundred patients met the selection criteria. The rate of infection was not significantly different across the SWC grades (<i>P</i> = 0.270). There was a significantly higher risk of SSI among patients with diabetes (<i>P</i> = 0.028). The Centers for Disease Control and Prevention SWC showed poor utility in predicting and risk stratifying postoperative SSIs in orthopaedic surgical cases.