SLR - November 2018 - Magdalena Marcinek

Time to Diagnosis and Treatment of Surgical Site Infections in Foot and Ankle Surgery

Reference: Baranek ES, Tantigate D, Jang E, Greisberg JK, Vosseller JT. Time to Diagnosis and Treatment of Surgical Site Infections in Foot and Ankle Surgery. Foot Ankle Int. 2018 Sep; 39(9): 1070–1075.

Scientific Literature Review

Reviewed By: Magdalena Marcinek, DPM
Residency Program: New York Presbyterian Queens, Flushing, NY

Podiatric Relevance:
Surgical site infections (SSIs) are known to be not only very common, but also very costly in the field of healthcare. The complications associated with surgical site infections cause financial burden for patients and the healthcare system. Baranek et al. find it necessary to quantify the time to definitive treatment of SSIs. They add that despite the fact that there exists a rich body of literature on the ways to prevent SSIs, there is little information on the exact time to development of the infection. The authors express their hope that costly complications of surgical site infections during foot and ankle surgeries can be prevented. As a result, the study can help reduce the cost of postsurgical infections, as well as psychological and physical traumas caused by them.

Methods: The authors completed a review of 1,933 procedures on ankles and feet of 1,632 patients during 2011 to 2015. The authors have utilized the medical records of almost 2,000 (1,933) surgeries on feet and ankles. They divided all patients into two groups: a group of patients who had surgical site infections and a group who developed wound complications. Collection of demographic and surgical data proved a highly effective and absolutely necessary method for arriving at the results of the research. Another method was an analysis of data related to wound complications.  

Results: 1,569 procedures met the various criteria of inclusion. Of all patients, only 17 had SSIs and 63 were wound complications. It turned out that the time between surgery and treatment in the group with wound complications was less than in the SSI group. It is also worth noting that 11 failed a trial of antibiotics prior to incision and drainage. Six SSI cases had no antibiotics prior to incision and drainage. They also found that antibiotics failed to lower the production of intraoperative wound cultures.  

Conclusion: The authors conclude that diagnosis-treatment time among the SSI group of patients turned out to be longer than among the patients who belonged to the wound complication group. It was also noted that SSIs that required surgical intervention only presented about a month postoperatively. The information presented in the study helps one better understand surgical site infections and may help to define SSI. 

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