Objectives: 

To compare infection rates after second-stage definitive surgery for high-energy tibial plateau fractures between groups of patients who had the external fixator prepped into the surgical field and those who did not.

Design: 

Retrospective cohort study.

Setting: 

Two academic Level 1 trauma centers.

Patients/Participants: 

Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions.

Intervention: 

Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the prepped group, and 82 patients were in the nonprepped group.

Main Outcome Measurements: 

The primary outcome was the rate of deep infection after definitive fixation. Secondary outcome was operative time.

Results: 

There were no significant differences in infection rates between prepped (11.7%) and nonprepped (18.3%) groups (P = 0.162). Patients in the prepped groups had significantly decreased operative time (168.2 minutes vs. 221.9 minutes, P < 0.001) even after controlling for confounders in regression analysis.

Conclusions: 

There is no increased risk of infection associated with prepping and maintenance of the external fixator during definitive internal fixation for high-energy tibial plateau fractures. These data suggest that this practice may lead to shorter operative times as well.

Level of Evidence: 

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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高能量胫骨平台骨折分期内固定外固定器灭菌后感染率增加吗？

目标： 

比较将外固定架准备好进入手术野的患者组和未准备好外固定架的患者组在二期高能量胫骨平台骨折根治性手术后的感染率。

设计： 

回顾性队列研究。

环境： 

两个学术一级创伤中心。

患者/参与者： 

244 名患者符合 2 家机构的纳入和排除标准。

干涉： 

在二期切开复位内固定术中准备外固定架进入手术野。有准备组有 162 名患者，无准备组有 82 名患者。

主要结果测量： 

主要结果是最终固定后的深部感染率。次要结果是手术时间。

结果： 

准备 (11.7%) 和未准备 (18.3%) 组之间的感染率没有显着差异 ( P = 0.162)。即使在回归分析中控制混杂因素后，准备组患者的手术时间也显着缩短（168.2 分钟对 221.9 分钟，P < 0.001）。

结论： 

在高能量胫骨平台骨折的最终内固定期间，与外固定器的准备和维护相关的感染风险没有增加。这些数据表明，这种做法也可能导致更短的手术时间。

证据等级： 

治疗级别 III。有关证据等级的完整描述，请参阅作者须知。