Relationship between the timing of debridement of open fractures of lower extremity and the incidence of surgical site infection

Abstract

The optimal timing of debridement of open fractures has been a debatable topic for many years. The purpose of the present study was to evaluate the relationship between the timing of initial debridement and the development of subsequent infection in open long bone fractures of lower limb presenting to our institution. We did a retrospective cohort study in 89 cases of open long bone fractures of lower limb who had underwent wound debridement and fracture fixation. Patients were grouped as Group A (44 patients) in which debridement of open fractures were done within 12 hours of injury and Group B (45 patients) wherein debridement was carried out after 12 hours of injury. Out of 44 patients in group A, 21 patients had infection and 23 had no signs of infection at the end of 1 year. In group B, out of 45 patients, 19 were infected and 26 had no signs of infection at 1year follow-up. Statistical analysis showed that there was no significant relationship between the timing of debridement and infection rate (p value – 0.6). Hence open fractures can safely be debrided even after 12 hours of injury without increasing the chances of infection provided the antibiotics are started on time and the surgery is carried out by adequately rested and trained surgical team.