Risk Factors for Surgical Site Infection in Distal Radius Fracture Surgery

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dc.contributor.advisorZhang, Andrewen
dc.contributor.committeeMemberSammer, Douglasen
dc.contributor.committeeMemberKoehler, Danielen
dc.creatorDavis, Justin Joeen
dc.creator.orcid0000-0003-3140-6161
dc.date.accessioned2022-06-24T21:23:20Z
dc.date.available2022-06-24T21:23:20Z
dc.date.created2020-05
dc.date.issued2020-05-01T05:00:00.000Z
dc.date.submittedMay 2020
dc.date.updated2022-06-24T21:23:21Z
dc.descriptionThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.en
dc.descriptionPage ii is misnumbered as page iii.en
dc.descriptionThe student submitted 2 separate documents as part of his research project, and this is part 1 of 2. The second part has been uploaded to a separate record, which can be viewed at the Related URI listed in this record.en
dc.description.abstractPURPOSE: Surgical site infections (SSI) after distal radius surgery can introduce substantial morbidity and additional direct and indirect costs. The clearest risk factors for SSI are the use of externalized Kirschner wires (K-wires) or external fixation (ex-fix). The roles of other potential risk factors such as open injuries, diabetes mellitus, and tobacco use are less clear. The purpose of this study was to identify independent risk factors for SSI in distal radius surgery. METHODS: A retrospective study of 541 operative distal radius fractures over a 5-year period was performed. Potential risk factors for infection included surgery duration, externalized K-wires or ex-fix, diabetes mellitus, uncontrolled diabetes defined as a HgBA1c >7 documented within a 90-day perioperative period, open fracture, tobacco use, osteoporosis, gender, and age. A screening bivariate logistic regression was performed, followed by a multiple logistic regression of the selected independent variables, with SSI as the dependent variable. A p-value of <0.05 was considered statistically significant. RESULTS: Twenty fractures (3.7%) were complicated by post-operative SSI, and 521 (96.3%) were not. Uncontrolled diabetes with HgA1c >7 (OR = 7.83, p=0.002), the presence of an ex-fix or k-wires (OR =3.73, p=0.007), and tobacco use (OR=3.79, p=0.007) were significant independent predictors of SSI. Of note, while uncontrolled diabetes was an independent risk factor, the diagnosis of diabetes alone was not. CONCLUSIONS: Previously identified risk factors for SSI after distal radius surgery including the presence of externalized K-wires or ex-fix were confirmed in this study. Additionally, this study demonstrates that tobacco use and uncontrolled diabetes (HgA1c >7) are both independent risks factors for SSI. Notably, the presence of diabetes alone was not an independent risk factor, highlighting the importance of glycemic control. LEVEL OF EVIDENCE: Level IIIen
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc1333220352
dc.identifier.urihttps://hdl.handle.net/2152.5/9909
dc.language.isoenen
dc.relation.urihttps://hdl.handle.net/2152.5/9910
dc.subjectBone Wiresen
dc.subjectFracture Fixation, Internalen
dc.subjectPostoperative Complicationsen
dc.subjectRadius Fracturesen
dc.subjectSurgical Wound Infectionen
dc.titleRisk Factors for Surgical Site Infection in Distal Radius Fracture Surgeryen
dc.typeThesisen
dc.type.materialtexten
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineResearchen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameM.D. with Distinctionen

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