INFECTIOUS COMPLICATIONS IN MAJOR ORTHOPEDIC SURGERIES

Abstract

Major orthopedic surgeries, such as arthroplasties, complex fixations, and reconstructive procedures, represent highly complex and clinically impactful interventions. Despite technological advances and the implementation of infection control protocols, infectious complications remain a major challenge in this context, contributing to increased morbidity and mortality, prolonged hospital stays, the need for reoperations, and increased healthcare costs. This narrative review aimed to analyze the incidence, risk factors, etiological agents, and prevention and treatment strategies for infectious complications in major orthopedic surgeries. Surgical site and implant-associated infections, often related to biofilm formation, were found to be the most prevalent events, with a notable presence of Staphylococcus aureus and coagulase-negative staphylococci, in addition to an increase in the occurrence of multidrug-resistant Gram-negative bacilli. The main risk factors include chronic comorbidities, prolonged surgical time, and failures in antimicrobial prophylaxis protocols. Management strategies include targeted antibiotic therapy, revision surgical procedures, and, in severe cases, implant removal. It is concluded that prevention, based on standardized measures and strengthened epidemiological surveillance, constitutes the most effective approach to reducing the occurrence of these complications and improving clinical outcomes in patients undergoing major orthopedic procedures.