Early Post-Operative Wound Infection in Austin Moore Hemiarthroplasty in Enugu, Nigeria

Abstract

Background: Early post operative wound infection is usually seen within four weeks of orthopaedic operations 1.Use of foreign implants, operating on the elderly, the obese, diabetic or patients with other chronic diseases increase the risk further 2.This study reveals the incidence of early infection and associated factors among patients who had Austin Moore hemiarthroplasty [AMH] in our centre over a ten year period
Method: Hospital records of 46 out of 59 patients who had AMH at the National Orthopaedic Hospital, Enugu between 1995 and 2004 (10yr periods) were reviewed retrospectively. 13 patients with incomplete records were excluded.
Results: The patients\' ages ranged from 26 to 99yrs with 67yrs as the mean age. There was slight female preponderance. Majority of our patients presented late [76%]. Only 2 patients presented within 24hrs of injury. 89.1% of our patients had femoral neck fracture as indication for hemiarthroplasty, with trivial falls at home and RTA as the leading causes of injury (54.3% and 32% respectively). Most of the patients had co-morbid medical conditions with hypertension predominating [76%]. Eight patients were diabetic 6 of who were also hypertensives. 87% of the patients were transfused. Wound infection was the commonest complication (26.1%). The most common infecting organism was coliform bacteria [33%,] others included staphylococcus aureus, proteus sp, klebsiela sp and pseudomonas sp. All the patients had prophylactic as well as presumptive antibiotic treatment. 43.5% of patients had ceftriaxone and metronidazole. This combination is both the commonest and most effective against infection. Use of gentamicin was uncommon. Majority of the infection was superficial (74.4%) and were treated with antibiotics and wound dressing. Those with deep infection had incision and drainage or removal of the prosthesis in addition.


Keywords: Early postoperative wound infection; Austin
Moore hemiarthroplasty, Elderly patients.

Nigerian Journal of Orthopaedics and Trauma Vol. 7 (1) 2008 pp. 1-2