Third day laboratory follow-up
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Third day laboratory follow-up : mandatory for surgical site infections of tibial plateau fractures. / Ballhause, Tobias Malte; Krause, Matthias; Roß, Julien; Rueger, Johannes Maria; Frosch, Karl-Heinz; Klatte, Till Orla.
In: EUR J TRAUMA EMERG S, 29.09.2019.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Third day laboratory follow-up
T2 - mandatory for surgical site infections of tibial plateau fractures
AU - Ballhause, Tobias Malte
AU - Krause, Matthias
AU - Roß, Julien
AU - Rueger, Johannes Maria
AU - Frosch, Karl-Heinz
AU - Klatte, Till Orla
PY - 2019/9/29
Y1 - 2019/9/29
N2 - INTRODUCTION: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
AB - INTRODUCTION: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
U2 - 10.1007/s00068-019-01232-z
DO - 10.1007/s00068-019-01232-z
M3 - SCORING: Journal article
C2 - 31535161
JO - EUR J TRAUMA EMERG S
JF - EUR J TRAUMA EMERG S
SN - 1863-9933
ER -