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Abstract

RÉSUMÉ
Introduction. La survenue d’une infection du site opératoire (ISO) en chirurgie orthopédique et traumatologique est une véritable catastrophe qui peut ruiner le bénéfice d’une intervention. Ce travail avait pour but de déterminer l’incidence et les facteurs prédictifs de survenue des ISO en chirurgie orthopédique et traumatologique propre à Yaoundé. Patients et méthodes. Nous avons réalisé une étude de cohorte prospective multicentrique. Tous les patients âgés de 18 ans ou plus, admis pour une chirurgie orthopédique et traumatologique de classe 1 d’Altemeier, du 1er janvier au 30 juin 2023, dans 4 hôpitaux universitaires de Yaoundé, étaient inclus dans cette étude. Les patients ont été suivis jusqu’à J30 postopératoire à la recherche d’une ISO définie selon les critères CDC (Centers for Disease Control and Prevention) 2018. Une analyse multivariée par régression logistique binaire a été utilisée pour rechercher les facteurs prédictifs de survenue d’ISO. Résultats. Au total 253 patients ont été inclus dans l’étude, dont 156 (61.7%) étaient des hommes, pour un âge moyen de 44,4 ± 16,5 ans. L’ostéosynthèse interne des fractures (83,4%) et les arthroplasties (11,0%) étaient les principales indications chirurgicales. L’incidence des ISO était de 9,5%. En analyse multivariée, le seul facteur prédictif indépendant d’une ISO était la survenue d’une fièvre post opératoire (aOR=0,052 ; IC à 95% : 0,003-0,0887 ; p= 0,041). Conclusion. Malgré les progrès observés en chirurgie orthopédique et traumatologique propre dans notre environnement, l’incidence de l’ISO reste relativement élevée. Une fièvre survenant à partir du 5ème jour postopératoire est un facteur prédictif indépendant d’ISO.
ABSTRACT
Introduction. The occurrence of a surgical site infection (SSI) in orthopedic and trauma surgery is a disaster that can ruin the benefit of an intervention. This study aimed to determine the incidence and predictive factors for the occurrence of SSI in clean orthopedic and trauma surgery in Yaoundé. Patients and methods. We carried out a prospective multicenter cohort study. All patients aged 18 years or older, admitted for Altemeier class 1 orthopedic and trauma surgery, from January 1 to June 30, 2023, in 4 university teaching hospitals in Yaoundé, were included in this study. The patients were followed-up until postoperative day 30 for SSI defined according to the CDC (Centers for Disease Control and Prevention) 2018 criteria. A multivariate logistic regression was used to determine the predictive factors for the occurrence of SSI. Results. A total of 253 patients were included in the study, of whom 156 (61.7%) were men, for a mean age of 44.4±16.5 years. Internal fixation of fractures (83.4%) and arthroplasties (11.0%) were the main surgical indications. The incidence of SSI was 9.5%. The average time to occurrence of SSI was 12.5 ± 9.5 days. In multivariate analysis, the only independent predictive factor of SSI was the presence of postoperative fever (aOR = 0.052; 95% CI: 0.003-0.0887; p = 0.041). Conclusion. Despite the progress observed in clean orthopedic and trauma surgery in our environment, the incidence of SSI remains relatively high. A fever occurring in the postoperative period is an independent predictor of SSI.

Keywords

Surgical site infection, Clean orthopaedic and trauma surgery, Low-income country Infection du site opératoire, Chirurgie orthopédique-traumatologique propre, Pays à ressources limitées

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Fonkoue Loïc, Muluem Olivier Kennedy, Bessong Etienne, Ngongang Franck Olivier, Mohamadou Guiemse, Mebouinz Ferdinand, Ewolo Sike Gloria, Ngo Yamben Marie Ange, Tiagadigui Gustave, Bahebeck Jean, & Handy Eone Daniel. (2024). Incidence and Predictive Factors of Surgical Site Infection in Clean Orthopaedic and Trauma Surgery in Yaoundé: Incidence et Facteurs Prédictifs d’Infection du Site Opératoire en Chirurgie Orthopédique et Traumatologique Propre à Yaoundé. HEALTH SCIENCES AND DISEASE, 25(3 Suppl 1). https://doi.org/10.5281/hsd.v25i3 Suppl 1.5691
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