The effect of the timing of antibiotics and surgical treatment on infection rates in open long-bone fractures: a 9-year prospective study from a district general hospital.
OBJECTIVE
To determine whether a delay of greater than 6h from injury to initial surgical debridement and the timing of antibiotic administration affect infection rates in open long-bone fractures.


METHODS
We studied 248 consecutive open long-bone fractures in 237 patients over a 9-year period. The patients were followed until clinical or radiological union occurred or until a secondary procedure for non-union or infection was performed.


RESULTS
Surgical debridement was performed within 6h of injury in 62% of cases and after 6h in 38% of cases. Infection rates were 7.8% and 9.6%, respectively, and the difference was not statistically significant (p=0.6438). The timing of antibiotic administration was not significantly related to the infection rate.


CONCLUSIONS
Whilst open long-bone fractures should be treated expeditiously, we suggest that adherence to a 6h window has not been shown to affect infection rates nor has the timing of antibiotic administration during the acute phase.
Al-Arabi
Yassir B
YB
The Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom. yassir6@hotmail.com
Nader
Maher
M
Nader
Michael
M
Hamidian-Jahromi
Ali Reza
AR
Woods
D A
DA
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D050280:Arm Bones / Q000293:injuries / Q000601:surgery; D002444:Cefuroxime / Q000627:therapeutic use; D003646:Debridement; D017102:Fracture Healing; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007867:Leg Bones / Q000293:injuries / Q000601:surgery; D008795:Metronidazole / Q000627:therapeutic use; D011446:Prospective Studies; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014946:Wound Infection / Q000453:epidemiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002444:Cefuroxime