糖尿病桡骨远端骨折钢板固定手术部位感染的相关因素OA

Objective To explore the related factors of surgical site infection(SSI)in diabetic patients undergoing plate fixa-tion for distal radius fractures.Methods A retrospective analysis was conducted on 897 patients who suffered from diabetes mellitus and underwent palmar locking plate fixation for unstable distal radius fractures in the Henan Provincial Corps Hospital of Chinese Peo-ple's Armed Police Force from January 2012 to June 2023.The patients were divided into two groups based on whether SSI occurred.Univariate analysis was used to compare the factors,and binary variable multivariate logistic regression analysis was used to analyze the risk factors of SSI.The receiver operating characteristic(ROC)curve was used to evaluate the predictive ability of the model.Results Among the 897 patients,43 patients(4.79%)developed SSI.The results of univariate analysis showed that the SSI group was significantly younger than the non-SSI group,and the difference was statistically significant(P=0.029),and the SSI group proved significantly higher than the non-SSI group in terms of proportion of male,smoking,American Society of Anesthesiologists(ASA)clas-sification,general anesthesia ratio[n,general/region,bone grafting ratio and blood loss,and the differences were statistically signifi-cant(P<0.05).Regarding preoperative laboratory tests,the SSI group had significantly higher white blood cell count,whereas signifi-cantly lower red blood cell count,hemoglobin,hematocrit,sodium,and albumin than the non-SSI group,and the differences were sta-tistically significant(P<0.05).Multivariate logistic regression analysis demonstrated that male gender(OR=2.83,95%CI:1.33～5.99,P=0.007),ASA classification Ⅳ(OR=4.41,95%CI:1.47～13.25,P=0.008),smoking(OR=2.37,95%CI:1.20～4.69,P=0.013),and bone grafting(OR=3.20,95%CI:1.18～8.68,P=0.022)were independent risk factors for SSI develop-ment.The area under the ROC curve of the predictive model was 0.771,demonstrating good discriminative ability.Conclusions For diabetic patients undergoing palm locking plate treatment for unstable distal radius fractures,special attention should be paid to high-risk patients such as males,those with worsened systemic diseases,those with a smoking history,and those requiring bone grafts.It is recommended to quit smoking before the surgery,strictly optimize blood sugar control,reasonably select indications for bone grafting,strengthen infection prevention measures during the perioperative period,and develop individualized monitoring plans to reduce the risk of surgical site infection and improve patient prognosis.