Surgical Site Infection in Orthopedics in a Country with LimitedResources: Indications, Treatment and Results

Authors: Muluem OK , Nyankoue MF , Nyekel JR , Elomo A , Tsiagadigui JG , Guemse ME and Handy ED

DOI: 10.23880/jobd-16000290

Volume 9, Issue 2

Abstract

Introduction: Treating surgical site infection (SSI) remains a challenge for surgeons in sub-Saharan Africa and the West. This study aimed to present the surgical indications and results obtained in managing SSI in orthopaedics and traumatology in a developing country.Patients and Method: This was a descriptive cross-sectional study carried out in the orthopaedics and traumatology department of a teaching hospital in the city of Yaounde over 5 years. It included all patients who had presented with postoperative infection after orthopaedic or traumatological surgery and who had undergone surgical management. The Student's t-test was used for the comparison of quantitative variables, and the Chi-Square or Fisher's Exact test for qualitative data.Results: Of the 65 cases collected, 61 cases (94%) had deep and 4 cases (6%) superficial SSIs. Pus was found in 98% of cases.The surgical indications were DAIR (Debridement Antibiotic Implant Retention) in 21 cases (32%), DAIEX (Debridement Antibiotic Implant Exchange) in 17 cases (26%) and DROM (Debridement and Removal of Osteosynthesis Material) in 18 cases (28%), DAIS (Debridement Antibiotic Implant Sterilization) in 5 cases (8%). Four patients did not undergo surgery. Culture was positive in 95% of cases, and 104 germs were isolated. The main ones were Staphylococcus aureus (23%),Klebsiella pneumoniae (14%), Enterobacter Cloacae (13%) and Escherichia coli (11%). The postoperative course of patients was marked by recovery without sequelae in 43 cases (66%), with sequelae in 13 cases (20%), and recurrence of infection in 9 cases (14%). There was no association between the type of surgical indication and recurrence of infection.Conclusion: The key to curing SSI is early diagnosis, with timely management combining surgery and antibiotic therapy.

Keywords: Surgical Site Infection; Debridement; Implant Removal; Implant Retention; Implant Replacement; Antibiotic Therapy

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