Background: Surgical repair of an Achilles tendon rupture has been shown to decrease rerupture rates. However, surgery also increases the risk of complications, including infection. Purpose: To determine the risk factors for infection and rerupture after primary repair of Achilles tendon ruptures. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was performed on 423 patients who underwent operative treatment of Achilles tendon ruptures between the years 2008 and 2014. The primary outcome of interest was the total rate of infection, and the secondary outcome of interest was the incidence of rerupture within 2 years of operation. Results: A total of 423 patients were analyzed, with a mean age of 46 years (range, 16-83 years) and a mean body mass index of 31.4 kg/m~(2)(range, 17-55 kg/m~(2)). The overall infection rate was 2.8%, and the rerupture rate was 1%. The median time between surgery and superficial surgical site infection was 30 days, and the median time between surgery and rerupture was 38 days. Longer tourniquet times (100.3 ± 34.7 minutes vs 69.9 ± 21.4 minutes; P = .04) and greater estimated blood loss (15.0 ± 9.1 mL vs 5.1 ± 12.0 mL; P = .01) were associated with an increased rate of deep surgical site infections. Patients who had longer operation and tourniquet times trended toward higher rerupture rates ( P = .06 and .08, respectively). When compared with nonsmokers, current and previous smokers had an increased incidence of superficial or deep surgical site infections (6.25% vs 1.42%; P = .02). Age, sex, race, body mass index, alcohol use, diabetes, past steroid injections, and mechanism of injury did not contribute to complication rates. Conclusion: Achilles tendon repairs were associated with a low risk of infection and rerupture. Patients with longer tourniquet times, higher estimated blood loss, and a history of smoking were at increased risk for surgical site infections. Patients with longer operative times had increased rates of rerupture.
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机译：背景：跟腱断裂的手术修复已显示降低了复发率。但是，手术也增加了并发症的风险，包括感染。目的：确定初次修复跟腱断裂后感染和复发的危险因素。研究设计：队列研究;证据等级，3。方法：对2008年至2014年间接受跟腱断裂手术治疗的423例患者进行了回顾性研究。主要关注目标是总感染率，次要关注因素是手术2年内破裂的发生率。结果：共分析423例患者，平均年龄46岁（范围16-83岁），平均体重指数31.4 kg / m〜（2）（范围17-55 kg / m〜 （2））。总体感染率为2.8％，复发率为1％。手术与浅表手术部位感染之间的中位时间为30天，而手术与复发之间的中位时间为38天。更长的止血带时间（100.3±34.7分钟vs 69.9±21.4分钟; P = .04）和更大的估计失血量（15.0±9.1 mL vs 5.1±12.0 mL; P = .01）与深部手术部位发生率增加相关感染。手术时间和止血带时间更长的患者趋向于更高的复发率（分别为P = 0.06和.08）。与不吸烟者相比，当前和以前的吸烟者浅表或深部手术部位感染的发生率增加（6.25％比1.42％; P = .02）。年龄，性别，种族，体重指数，饮酒，糖尿病，既往类固醇注射和损伤机制无助于并发症发生率。结论：跟腱修复与感染和复发的风险低有关。止血带时间更长，估计失血量更高和有吸烟史的患者手术部位感染的风险增加。手术时间较长的患者的复发率更高。
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