Efficacy of cultures in the management of open fractures.
Two hundred forty-five open fractures were reviewed retrospectively to determine the prognostic value of wound bacterial cultures concerning deep infections requiring surgical management. Only 8% of organisms grown on predebridement cultures eventually caused infection; 7% of cases with negative predebridement cultures became infected. Of cases that did become infected, predebridement cultures grew the infecting organism only 22% of the time. Postdebridement cultures were more accurate in predicting infection; however, of cases that became infected, the infecting organism was present on postdebridement cultures only 42% of the time. It is concluded that predebridement and postdebridement bacterial cultures from open fracture wounds are of essentially no value, and it is recommended that they not be done.
Lee
J
J
University of California, Davis Medical Center, Sacramento, USA.
D003646:Debridement; D005597:Fractures, Open / Q000145:classification / Q000382:microbiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology*; D016896:Treatment Outcome