Is Kirschner Wire (K-wire) Infection Risk Higher when Operated by Junior Surgeons?–Infection Rates of K-wire Fixation in a UK Plastic Surgery Hand Trauma Unit

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Hand injuries such as fractures and dislocations are commonly managed with K-wires. Studies assessing K-wire complications suggest an infection rate between 6.6% to 33%.[ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] Our local hand trauma unit perceived an increase in frequency in K-wire infections. Therefore, we assessed our local hand injury K-wire infection rate and its associated factors. The primary outcome was to identify the infection rate while the secondary outcome was to compare injury, surgical and postoperative factors of cases which developed infections compared with those which did not. This retrospective analysis included all cases (adult and pediatric) requiring at least one K-wire fixation in the plastic surgery trauma theater lists between August and December 2019. Data collected included the following: patient demographics, injury characteristics, surgery characteristics, timing of appointments, and follow-up. We identified 54 cases: 46 noninfected and 8 infected, leading to an infection rate of 15% ([ Fig. 1a ]). Differences between demographics ([ Fig. 1b ]), injury characteristics and surgical characteristics such as K-wire number, antibiotic prophylaxis and follow-up were not statistically significant. Interestingly, 59% of noninfected cases and 100% of infected cases were operated by junior surgeons (registrars), and this difference was statistically significant ( p = 0.015, [ Fig. 1c ]); however, the registrar grade (junior vs. senior registrar) difference was not ( p = 1). Additionally, we noted that differences in the degree of involvement of the senior supervisor (consultant) was statistically significant ( p = 0.0007, [ Fig. 1d ]). For a summary of the results and their statistical analyses, please see [ Table 1 ]. Table 1

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