Surgical site infection in primary care following surgery for hand trauma in adults

Date of Approval
Application Number
21_000336
Technical Summary

Hand and wrist trauma is common, accounting for 1-in-5 A&E attendances, with an incidence of over 130,000
injuries/year in the UK. The hand and wrist are important for social, occupational and recreational activities.
Injury to this important functional unit can cause significant short and long-term morbidity. Surgical site infection
(SSI) in hand and wrist trauma surgery affects people in terms of additional interventions and prolonged
recovery but has been poorly researched.

Methods:
A population-based cohort study of adult patients in primary care that have had surgery for hand and wrist trauma over the last 22 years.

Participants:
All patients registered in the Clinical Practice Research Datalink (CPRD) database with at least 1-year follow-up
available pre-inclusion, who have undergone surgery for hand and wrist trauma.

Data sources:
I will use pseudonymised NHS primary care (CPRD Gold) provided by CPRD (www.cprd.com). We are replicating this study in similar primary care databases internationally, and are not requesting HES linkage for comparability.

Outcomes: Surgical site infection

Measurements: Counts of hand and wrist trauma surgery, counts of post-operative/surgical site infection, prescription, analysis of specific co-morbidities that may increase risk of SSI

Statistics: SSI incidence rates will be calculated as the proportion of the population registered in any contributing practice in a given calendar year who develop SSI following hand and wrist trauma surgery for the first time in their records in that same year. Stratified rates will be obtained by sex and age groups. Univariate then multivariate logistic regression will be used to examine the association of risk factors of interest on developing SSI (including smoking status, diabetes, obesity, and immunosuppressive medication).

Health Outcomes to be Measured

Incidence of surgical site infection following surgery for hand and wrist trauma

Collaborators

Justin Wormald - Chief Investigator - Nuffield Dept of Orthopaedics
Daniel Prieto-Alhambra - Corresponding Applicant - University of Oxford
Jeremy Rodrigues - Collaborator - University of Oxford
Jonathan Cook - Collaborator - University of Oxford
Matthew Costa - Collaborator - University of Oxford