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Cohort studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026

Elevated risk of wound and systemic complications in MRSA-colonized patients undergoing lower extremity orthopedic trauma surgery.

Aruni S Areti, Harris Hafeez, Pradyun V Sangineni … Jack Dawson

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Internal MedicineCohort study

Methicillin-resistant Staphylococcus aureus colonization before lower-limb trauma surgery is linked to higher odds of sepsis

Elevated risk of wound and systemic complications in MRSA-colonized patients undergoing lower extremity orthopedic trauma surgery.

Aruni S Areti … Jack Dawson

European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026

Background

Preoperative colonization with methicillin-resistant Staphylococcus aureus (methicillin-resistant Staphylococcus aureus) is a known risk factor for adverse outcomes in arthroplasty but remains under-investigated in orthopedic trauma.

Purpose

This study evaluates the impact of preoperative methicillin-resistant Staphylococcus aureus colonization on postoperative complication rates in patients undergoing lower extremity orthopedic trauma surgery.

Methods

With a documented methicillin-resistant Staphylococcus aureus diagnosis within three months before surgery were matched 1:1 to methicillin-resistant Staphylococcus aureus-negative controls based on demographics and comorbidities.

n = 629,342 control

Results

far higher odds of sepsis, a dangerous body-wide reaction to infection

Sepsis

3.71OR

Pulmonary embolism

2.8OR

Pneumonia

2.33OR

DVT

2.29OR

More results

A total of 1,868 methicillin-resistant Staphylococcus aureus+ and 629,342 control patients were identified.

No significant differences in surgical site infections were observed after matching.

“

Conclusion · 1 of 3

Preoperative methicillin-resistant Staphylococcus aureus colonization is associated with increased risks of wound dehiscence, pneumonia, sepsis, thromboembolic events, blood transfusions, and acute renal failure in orthopedic trauma patients.

Conclusion · 2 of 3

Preoperative methicillin-resistant Staphylococcus aureus screening may serve as a risk-stratification tool, enabling surgeons to anticipate systemic complications and optimize management.

Conclusion · 3 of 3

Where feasible, screening with targeted decolonization or prophylactic strategies may mitigate risk.

Post

Elevated risk of wound and systemic complications in MRSA-colonized patients undergoing lower extremity orthopedic trauma surgery.

Methicillin-resistant Staphylococcus aureus colonization before lower-limb trauma surgery is linked to higher odds of sepsis

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