{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:02:50Z","timestamp":1780470170748,"version":"3.54.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical site infection (SSI) following posterior internal fixation of thoracolumbar fractures constitutes a severe complication that adversely impacts patient recovery. Despite its clinical significance, there remains a paucity of research investigating the risk factors associated with SSI. Therefore, this study aimed to explore these risk factors and propose potential therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 157 patients who underwent posterior internal fixation for thoracolumbar fractures at the Department of Orthopedics, Affiliated Hospital of Yan\u2019an University, between February 2017 and October 2021. Patients were stratified into an infection group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) and a non-infection group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009145). Preoperative baseline data included age, gender, body mass index, total protein (TP), albumin (ALB), hemoglobin (HB), red blood cell count (RBC), white blood cell count (WBC), total lymphocyte count (TLC), platelet count (PLT), and the presence of diabetes or hypertension. Operative data encompassed preoperative preparation time, length of the surgical incision, number of internal fixation segments, operation duration (\u22653\u2005h vs. &amp;lt;3\u2005h), occurrence of allogeneic blood transfusion, intraoperative blood loss (\u2265400\u2005mL vs. &amp;lt;400\u2005mL), and type of drainage tube (negative-pressure vs. normal). Postoperative management-related data included dressing changes at the surgical incision within 24\u2005h following the operation, indwelling time of the drainage tube (\u22653 days vs. &amp;lt;3 days), drainage volume upon removal of the drainage tube (\u226550\u2005mL vs. &amp;lt;50\u2005mL), reoperation requirement, and postoperative levels of TP, ALB, HB, RBC, WBC, TLC, and PLT. Eligible data were subjected to univariate analysis, followed by multivariate logistic regression for variables with significant univariate associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Univariate analysis revealed significant differences between groups in intraoperative blood loss (\u2265400\u2005mL), preoperative ALB (&amp;lt;30\u2005g\/L), preoperative RBC, postoperative HB, postoperative RBC, surgical incision length, and number of internal fixation segments between groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Multivariate logistic regression analysis identified preoperative hypoalbuminemia (&amp;lt;30\u2005g\/L) [odds ratio (OR)\u2009=\u20090.851,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028] and intraoperative blood loss (\u2265400\u2005mL) (OR=7.477,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) as independent risk factors for SSI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative hypoalbuminemia (&amp;lt;30\u2005g\/L) and intraoperative blood loss (\u2265400\u2005mL) are associated with an elevated risk of SSI following posterior internal fixation of thoracolumbar fractures. Implementing effective perioperative management strategies is crucial to mitigate the incidence of SSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1741838","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:06:11Z","timestamp":1780466771000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for surgical site infection following posterior internal fixation of thoracolumbar fractures"],"prefix":"10.3389","volume":"13","author":[{"given":"Pengxi","family":"He","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ren","sequence":"additional","affiliation":[{"name":"First Orthopedic Ward, Yan'an People's Hospital","place":["Yan'an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenshen","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Spine, Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong Province, China"]},{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Yan\u2019an University","place":["Yan\u2019an, Shaanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"42653","DOI":"10.1038\/s41598-025-26870-9","article-title":"Identifying predictors of surgical site infection in closed patellar fracture surgery: a multicenter study","volume":"15","author":"Yang","year":"2025","journal-title":"Sci Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3810","DOI":"10.1097\/JS9.0000000000002371","article-title":"Association between generation of cephalosporins and surgical site infection in open fractures: a prospective cohort study","volume":"111","author":"Yang","year":"2025","journal-title":"Int J Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1177\/19386400241313418","article-title":"Determination of pathogens in surgical site infections in ankle fractures and implications for empirical antibiotic treatment","volume":"18","author":"Plasmeijer","year":"2025","journal-title":"Foot Ankle Spec"},{"key":"B4","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1177\/17531934241264110","article-title":"Re: Crook et al. 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