title: 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.
abstract: 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.
authors.affiliation: The Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom. yassir6@hotmail.com
authors.forename: Yassir B
authors.initials: YB
authors.lastname: Al-Arabi
authors.forename: Maher
authors.initials: M
authors.lastname: Nader
authors.forename: Michael
authors.initials: M
authors.lastname: Nader
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Hamidian-Jahromi
authors.forename: D A
authors.initials: DA
authors.lastname: Woods
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002444:Cefuroxime