Study: OR size has ‘significant role’ in the development of surgical site infection
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Medium-sized ORs, younger patients, longer emergency and trauma procedures and higher American Society of Anesthesiologists scores are risk factors for the development of surgical site infection, according to published results.
In a retrospective review, researchers analyzed data from 11,163 patients who underwent total hip arthroplasty, total knee arthroplasty, laminectomy and spinal fusion between Jan. 1, 2018 and Jan. 1, 2020 to determine associations between OR size and rates of surgical site infection (SSI).
According to the study, SSI was defined as a superficial or deep infection developing within 30 days after surgery or within 90 days if implantable hardware was present. OR size was calculated by total net square footage (NSF) and categorized as small (250 to 399 NSF), medium (400 to 549 NSF) and large (550 to 699 NSF). Researchers also performed binary logistic regression to identify other perioperative parameters that impacted the incidence of SSIs.
Overall, 1.2% of patients (n = 137) developed an SSI, an incidence rate that “falls within the rates described in the literature,” the researchers wrote in the study. Patients undergoing spinal fusion had the highest incidence of SSI (2.6%), followed by laminectomy (1.9%), THA (1.2%) and TKA (0.6%).
Researchers found 11.7% of infections occurred in small ORs, 60.6%occurred in medium ORs and 27.7% occurred in large ORs. They also noted binary logistic regression revealed several independent risk factors for increased SSI incidence: medium-sized ORs, fusion procedures, younger patients, longer procedure duration, emergency and/or trauma procedures and higher ASA scores.
“OR size has a significant role in the development of orthopedic SSIs,” the researchers wrote. “Future prospective studies should further isolate OR size as a key factor in SSI development. Findings can ultimately guide future construction of ORs for improved workflow and SSI reductions,” they wrote.
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