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POSTER Top-02 FFN 2013
Surgical wound infections in
hip fracture patients
Mette Martinsen1, Anette Hylen Ranhoff2, Ludvig Fjeld Solheim1
1 Surgical department, Diakonhjemmet hospital, 0319 Oslo, Norway
2 Medical department, Diakonhjemmet hospital, 0319 Oslo, Norway
Contact info: [email protected]
Introduction
Methods
• Surgical wound infection in hip fracture patients is a severe complication
• There are few studies looking at measurements to prevent such infections
Observational study, comparing patients who
were given a bath to those who were not. Data
was obtained from a quality register containing
demographic and medical information.
Patients were randomly given a bath using
disinfectant or washed with the same disinfectant
before surgery. Data about shower/wash and postoperative observations were collected from the
nurse’s journal.
The aim is to study whether pre-operative
bathing using a disinfectant can contribute to prevent surgical wound infections
Results
• 900 patients were included from
01.01.2011 - 31.12.2012
• 692 (77 %) were women
• Age 65-103 yrs, mean 84.7 yrs (+/-7.9)
• 473 patients were given a bath and 426 were washed before surgery.
• Surgical wound infections were registered in
33 (3.7 %) patients.
Figure 1: Prevalence of surgical wound infections in patients given
bath vs no bath
5,5
5
4,5
4
Patients with
surgical wound
infections
(n=33)
Patients without surgical
wound infections
(n=867)
P value
Gender:
Women, n (%)
Men, n (%)
27 (3.9)
6 (2.9)
665 (96.1)
202 (97.1)
0.33
Age, mean (SD) years
87.6 (7.5)
84.6 (7.9)
0.03
ASA score n=885
Low (I-II), n (%)
High (III-IV), n (%)
16 (48.5)
17 (51.5)
353 (41.4)
499 (58.6)
0.26
Number of chronic diseases
(Charlsons index), mean (SD) 1.45 (1.03)
1.13 (1.04)
0.07
Dementia, n (%)
14 (42.4)
224 (25.8)
0.04
Diabets, n (%)
4 (12.1)
60 (6.9)
0.20
Number of complications mean
1.1
0.9
0.27
Delirium, n (%)
13 (39.4)
225 (26.0)
0.11
Bloodtransfusion
10 (30.3)
190 (21.9)
0.29
Preoperative bath n %):
Yes
No
11 (33.3)
22 (66.7)
463 (53.5)
403 (46.5)
0.03
Table 1: Characteristics in patients with surgical wound
infections vs patients without surgical wound infection n=900
3,5
3
Bath
2,5
No bath
2
1,5
1
0,5
0
Unadjusted
Adjusted for, sex, age, ASA-score,nuber
of Chronic disease and dementia
Conclusions
Preoperative bathing of the patients using a disinfectant may
prevent surgical wound infections in older hip fracture patients.
Further studies on measurements to prevent such infections
are needed.
Diakonhjemmet Hospital is the local hospital for approxiamately 130 000 inhabitants living in the western sectors of Oslo.
The hospital provides medical services in the fields of internal medicine, surgery, intensive medicine, rheumatology and rheumatology surgery, as well as psychiatry.
• The hospital has extended responsibility for treating patients in the fields of rheumatology and rheumatology surgery form the whole health region
• The hospital is a competence center in the fields of rheumatology and psychopharmacology, and has an extended research activity - especially within these areas
• Health services for the elderly has a special focus at Diakonhjemmet. The hospital is responsible for the treatment of people 65 years of age or older with hip fractures,
in an extended area of Oslo, as well as for elderly patients in need of psychiatric health services
The four core values of Diakonhjemmet Hospital are respect, quality, service and justice.