Identifying predictors of surgical site infection in closed patellar fracture surgery: a multicenter study

$Identifying predictors of surgical site infection in closed patellar fracture surgery: a multicenter study$

Introduction

Surgical site infection (SSI) remains one of the most common and concerning complications in orthopedic procedures. These infections can increase patient morbidity, prolong hospital stays, and escalate healthcare costs. Identifying risk factors for SSI after closed patellar fracture surgery helps surgeons improve outcomes and reduce postoperative complications.

Methods

This multicenter observational study analyzed patients undergoing surgical treatment for closed patellar fractures. Data were collected from multiple hospitals to ensure a representative and reliable sample. Researchers examined demographic variables, preoperative conditions, intraoperative details, and postoperative management to identify independent predictors of SSI.

Variables studied

Patient age and sex
Body mass index (BMI)
Presence of diabetes mellitus or smoking history
Operative time and surgical approach
Type of fixation device used
Use of prophylactic antibiotics and wound care methods

Statistical analysis

Multivariate logistic regression was applied to identify factors independently associated with SSI. Significance was defined at p < 0.05.

Results

The overall incidence of SSI among patients with closed patellar fractures was identified, showing a measurable rate higher than expected in some centers. Patients with longer operative times, high BMI, diabetes, and smoking history had a notably greater risk of developing an infection.
Use of proper antibiotic prophylaxis and meticulous surgical technique significantly reduced infection rates.

Discussion

The findings highlight modifiable and non-modifiable factors affecting SSI risk. While patient-related factors like diabetes or smoking are difficult to alter immediately, surgical factors—including operating time and perioperative antibiotic administration—can be optimized to reduce infection.

“Meticulous soft tissue handling and adherence to prophylactic protocols remain key in minimizing surgical site infection.”

Conclusion

Effective infection control strategies should be tailored to patient risk profiles. Early identification and management of modifiable risk factors can significantly reduce postoperative SSI rates in closed patellar fracture surgeries.

Author summary:
A multicenter study found that longer surgery duration, obesity, diabetes, and smoking increase infection risk after patellar fracture repair, underscoring the value of preventive surgical practices.

Nature — 2025-11-28