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Third day laboratory follow-up: mandatory for surgical site infections of tibial plateau fractures
- Source :
- European Journal of Trauma and Emergency Surgery. 47:581-587
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Tibial plateau fractures are common fractures in adults and can be extremely challenging for surgeons. State-of-the-art therapy is open reduction and internal fixation (ORIF), although major complications of ORIF are surgical site infections (SSIs). This is especially critical on the proximal tibia, which is only sparsely covered by soft tissue and has a close relation to the knee joint. We analyzed SSIs after ORIF to correlate established laboratory parameters to the occurrence of SSIs. A monocentric case–control study in a Level 1 Trauma Center was conducted. Data were acquired from electronic medical records from 2011 until 2016. White blood cell count (WBC) and C-reactive protein (CRP) were used as laboratory parameters and statistically analyzed. In total, 97 patients were included, with four patients suffering from SSIs. Patients with SSIs had a significantly increased WBC count and CRP levels on the third postoperative day. Infection was diagnosed after rehospitalization, 12 ± 4 weeks after initial surgery. Furthermore, a large bony destruction through trauma coincides with a rise of WBC count with no influence on CRP level. We highly recommend a laboratory analysis with WBC count and CRP on the third day after ORIF. Patients with a CRP level above 100 mg/l should be closely watched, even if laboratory parameters few days later are adequate—since a one-time increase above this landmark might be a hint regarding the development of a SSI.
- Subjects :
- medicine.medical_specialty
Sports medicine
medicine.medical_treatment
Critical Care and Intensive Care Medicine
Fracture Fixation, Internal
03 medical and health sciences
0302 clinical medicine
White blood cell
Surgical site
Humans
Surgical Wound Infection
Medicine
Internal fixation
Orthopedics and Sports Medicine
Major complication
Retrospective Studies
030222 orthopedics
business.industry
Medical record
Trauma center
Soft tissue
030208 emergency & critical care medicine
Surgery
Tibial Fractures
Treatment Outcome
medicine.anatomical_structure
Case-Control Studies
Emergency Medicine
Laboratories
business
Subjects
Details
- ISSN :
- 18639941 and 18639933
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- European Journal of Trauma and Emergency Surgery
- Accession number :
- edsair.doi.dedup.....caf0f900adcfdf97bd0e3077c8b7a8ed