Information technologies for supporting prevention, diagnosis and management of surgical site infections in trauma and orthopedic patients

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Abstract

BACKGROUND: Surgical site infections (SSIs) are one of the most common preventable healthcare-associated infections, with a significant socioeconomic burden. Information technology, particularly clinical decision support systems, has been shown to improve patient safety. However, there have been few publications on the use of these systems for the prevention and treatment of SSIs.

AIM: To develop a multifunctional patient safety information system (PSIS) for the prevention, diagnosis, and treatment of SSIs in traumatic and orthopedic surgery.

MATERIALS AND METHODS: A PSIS for traumatic and orthopedic surgeons was developed and implemented in the N.N. Priorov National Medical Research Center of Traumatology and Orthopedics in late 2023 to early 2024. The PSIS includes two user systems: 1) an analytical and authoring system (PSIS-Manager) for subject matter experts who develop scenarios; 2) a medical system for patient data entry and access to guidelines.

RESULTS: A PSIS prevention scenario was developed based on the guidelines of the National Association of Infectious and Non-Infectious Disease Control Professionals. It includes 11 recommendations for the preoperative stage, 30 for the perioperative and intraoperative stages, 33 for SSI prevention during surgery, and 7 for the postoperative stage. A surgical antibiotic prophylaxis scenario includes 24 recommendations. Decision-making algorithms for the treatment of SSIs are based on the guidelines of the American Academy of Orthopaedic Surgeons (AAOS). Decision-making involves 6 factors providing 264 various clinical scenarios, with 9 decision options.

CONCLUSION: Scenario-based protocols can be used to support decision-making on patient management strategy, as well to control compliance with SSI prevention and treatment guidelines. Further perspectives on PSIS development in terms of SSI diagnosis and treatment include the use of artificial intelligence technologies to aid in the diagnosis of wound infections and the selection of treatment options.

About the authors

Anton G. Nazarenko

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: NazarenkoAG@cito.priorov.ru
ORCID iD: 0000-0003-1314-2887
SPIN-code: 1402-5186

MD, Dr. Sci. (Medicine), рrofessor

Russian Federation, Moscow

Elena B. Kleimenova

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: KleymenovaEB@cito-priorov.ru
ORCID iD: 0000-0002-8745-6195
SPIN-code: 2037-7164

MD, Dr. Sci. (Medicine), рrofessor

Russian Federation, Moscow

Mikhail A. Dronov

Priorov National Medical Research Center for Traumatology and Orthopedics; Lomonosov Moscow State University

Email: mikhail.dronov@gmail.com
ORCID iD: 0000-0002-4090-2928
SPIN-code: 8710-6504
Russian Federation, Moscow; Moscow

Dmitry S. Gorbatyuk

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: GorbatyukDS@cito-priorov.ru
ORCID iD: 0000-0001-8938-2321
SPIN-code: 7686-2123

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Nodari M. Kakabadze

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: KakabadzeNM@cito-priorov.ru
ORCID iD: 0000-0002-2380-2394
SPIN-code: 6321-6733

MD

Russian Federation, Moscow

Archil V. Tsiskarashvili

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: TsiskarashviliAV@cito-priorov.ru
ORCID iD: 0000-0003-1721-282X
SPIN-code: 2312-1002

MD, MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Natalia P. Gerasimova

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: GerasimovaNP@cito-priorov.ru
ORCID iD: 0000-0002-3330-3193
Russian Federation, Moscow

Ekaterina S. Yurchenkova

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: YurchenkovaES@cito-priorov.ru
ORCID iD: 0009-0006-2350-7201
Russian Federation, Moscow

Liubov P. Yashina

Priorov National Medical Research Center for Traumatology and Orthopedics

Author for correspondence.
Email: YashinaLP@cito-priorov.ru
ORCID iD: 0000-0003-1357-0056
SPIN-code: 1910-0484

Cand. Sci. (Biol.)

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Interface of the scenario development in ISPS-Manager.

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3. Fig. 2. Interface of the scenario editing in ISPS-Manager.

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4. Fig. 3. Home page of the Intellectual system for patient safety for physicians and auditors.

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5. Fig. 4. Filling out a surgical site infection prevention scenario by a physician.

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6. Fig. 5. Recommendations for the surgical site infections management.

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