JUSTIFICATION OF MEDICAL AND ORGANIZATIONAL ACTIVITIES ON PREVENTION IMPROVEMENT AND PROBABILITY ESTIMATION OF SURGICAL SITE INFECTION IN PATIENTS WITH BONE FRACTURES
Introduction: Injury remains a worldwide problem due to increased road and industrial accidents, as well as natural disasters. Treatment results of injuries are not always positive, whereas the most often injured group is the working-age population. The frequency of surgical site infections during operations performed in connection with bone fractures does not tend to decrease. Existing prognostic and prevention methods of purulent complications designated only for particular fractures. In this regard, the study of the organizational aspects of predicting the development and prevention of surgical site infections during operations performed in connection with bone fractures is relevant for medical science and practice.Materials and methods. A retrospective analysis of data on 487 patients operated in connection with bone fractures was carried out. Information on patients underwent surgical intervention without local infectious complications (421 cases - 86.4%) was compared with the data of injured, who were diagnosed with local infectious complications - 89 (18.3%) patients. Multivariate logistic regression model was used to screen for independent risk factors for the purulent complications development. The revealed risk factors were estimated prospectively in 984 patients underwent surgery for bone fractures within treatment-and-prophylactic institutions of the Republic of Crimea in 2016-2017. Preventive organizational measures were applied to risk group patients. Surgical site infections were observed in 105 (10.7%) patients a year after surgery.Results. When studying the information on a retrospective group of patients was formed the data base being the basis for the development of logistic regression models. Five criteria for predicting the development of infectious complications in the surgical site are identiﬁed: gender, age, presence of concomitant pathology, the risk for anesthesia by ASA and the interaction of individual factors. Organizational measures were developed that resulted in the decrease of surgical site infections during trauma surgeries from 18.3% to 10.7%.