Abstract: Objective To study the risk factors and preventive measures of postoperative nosocomial infection of open fracture of the upper limb.Methods Patients who underwent open upper extremity fracture surgery in a hospital in Haidong City from November 2015 to April 2018 were enrolled in this study. The incidence of postoperative nosocomial infection and related factors were analyzed.Results A total of 386 open fracture patients undergoing surgery were analyzed in this study, including 217 males and 169 females, aged 20-74 years. Of all the patients, 163 （42.2%） were suffered from the unilateral humeral fractures of the upper limbs as the main type. According to Gustilo classification, 159 cases were Type III A, 197 were III B, and 30 were III C. There were 35 cases of postoperative nosocomial infection, with an incidence rate of 9.07%. In the multivariate logistic stepwise regression model, patients with smoking history （OR=4.461）, type 2 diabetes （OR=4.249）, pulmonary hypofunction （OR=5.687）, Gustilo type III C （OR=2.161）, general anesthesia （OR=5.185）, duration of surgery ≥2.5 hours （OR=4.951）, intraoperative blood transfusion （OR=4.574）, indwelling catheterization time ≥7 days （OR=4.212）, hemoglobin <90 g/L （OR=2.154）, albumin ≤35 g/L （OR =5.780）, CD4+/CD8+<1 （OR=4.236） had a higher risk of postoperative nosocomial infection.Conclusion The incidence of postoperative nosocomial infection of open fracture of the upper limb was relatively high and its risk factors were varied. Screening of risk factors from time to time and preventive measures against high-risk groups should be strengthened for reducing the rate of nosocomial infection.

Key words: Upper limb open fracture, Nosocomial infection, Risk factors, Prevention