Correlation between carriers of Methicillin-resistant Staphylococcus aureus and the incidence of MRSA surgical site infections in orthopedic surgery patients.

OBJECTIVE: Surgical site infection (SSI) is a devastating complication in orthopedic surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a notorious organism in SSI, especially in orthopedic patients. We aimed to understand the association between MRSA carriers and the rate of SSI caused by MRSA in orthopedic patients. PATIENTS AND METHODS: We prospectively performed a cohort investigation on patients admitted to the Department of Orthopedic between April and August 2023. Samples were taken preoperatively from the nose and post-operatively in surgical wounds. All samples were grown in MeReSa Agar and defined as positive with MRSA characteristics. Data analysis was performed using SPSS Statistics. A significant difference between groups was assessed using either the Chi-square test or Fisher's exact test. Statistical significance was set at p<0.05. RESULTS: We obtained 526 nasal swabs of patients, and 140 (26.6%) samples were positive for MRSA. Our study revealed significant associations between MRSA carriers and the following factors: history of recent hospitalization (OR: 1.81; 95% CI: 1.172-2.795; p=0.007), smoking history (OR: 1.55; 95% CI: 1.011-2.383; p=0.044), and antibiotic exposures (OR: 2.19; 95% CI: 1.305-3.703; p=0.003). Our findings showed a significant association between SSI and the following factors: history of antibiotic exposures (OR: 2.89; 95% CI: 1.264-6.566; p=0.003), blood loss volume >500 ml (OR: 2.522; 95% CI: 1.245-5.108; p=0.008) and contaminated surgical wounds (OR: 5.97; 95% CI: 2.907-12.266; p=0.001). Patients with MRSA carriers tended to have an increased risk of having an MRSA SSI with an odds ratio of 3.44 (95% CI: 1.13-10.48; p=0.047). CONCLUSIONS: Our study highlights the increased risk of MRSA carriage in patients with a history of smoking, recent hospital admission, or antibiotic exposure. Our reports also identify potential risk factors for SSI, such as previous antibiotic exposure, blood loss, and contaminated wounds. Furthermore, our research establishes an association between MRSA colonization and MRSA SSI, which emphasizes the criticality of decolonization strategies. A further prospective multicenter study is needed to elaborate on our study findings.

Predicting the peroneus longus tendon autograft size in ACL reconstruction by using anthropometric parameters: A study in South Sulawesi population.

INTRODUCTION: Some literature use peroneus longus tendon (PLT) as the alternative to anterior cruciate ligament (ACL) reconstruction to overcome inadequate autograft size potential risk by using hamstring tendon (HT) autograft. Among the available methods to predict PLT measurements, anthropometric parameters are one of the most accessible and feasible methods. The objective of this prospective study was to predict the PLT autograft sizes in single bundle ACL reconstruction by using preoperative anthropometric measurement. METHOD: Anthropometric parameters, including age, gender, height, weight, body mass index (BMI), true leg length (TLL), shank circumference and shank length of 20 patients with primary ACL reconstruction was measured before surgery. Univariate analysis, independent-sample t-test, Pearson correlation test, and logistic regression to evaluate the influence of these anthropometric variables on the diameter and length of the PLT autograft obtained. RESULT: Pearson correlation test has shown that body weight and height correlates to PLT length and diameter also autograft's length and diameter significantly (p < 0.05). The linear regression analysis showed that height, weight, TLL and shank length were signifcantly related to autograft diameter. While height and TLL were significantly related to autograft length. CONCLUSION: Height, weight, TLL and shank length can use to predict PLT autograft diameter. While height and TLL can use to predict PLT autograft length.

Evaluación de resultados calificada por el paciente en el análisis la diferencia de resultado funcional entre Fijación distal del segundo y tercer metacarpiano de placa de distracción dorsal en conminutivo distal fractura de radio / Patient-rated outcomes evaluation in analyzing the difference of functional outcome between second and third metacarpal distal fixation of dorsal distraction plating in comminutive distal radius fracture

Introduction: Comminuted distal radius fracture is one of the fractures that difficult to reduce. This study aimed to compare Patient-Rated Wrist Evaluation (PRWE) score between plating on second and third metacarpal groups. Methods: This study used a retrospective analytic research design with a sample of twenty seven cases of distal radius comminutive fractures that have been treated using dorsal distraction plating. Fifthteen cases with distal fixation in second metacarpal and twelve cases in third metacarpal. Data were then analyzed using the Mann-Whitney test. Results: The mean Pain scores in the second metacarpal and third metacarpal groups, respectively were 5.73 compared to 6.17. While the mean score of Function in the second metacarpal group and the third metacarpal group, respectively 12.67 compared to 13.83. The total PRWE score in the second metacarpal group was 18.40 compared to the third metacarpal group which was 20.0 (p>0.05). Conclusions: Patients with distal radius comminuted fracture treated using dorsal distraction plating with distal fixation in second metacarpal showed higher mean Pain, Function and total PRWE compared to third metacarpal, but there were no significant differences