Observation on the Pattern of Bacterial Isolates in Compound Fractures

Introduction: The number of compound fractures is increasing day by day in developing countries. Cause for compound fractures are road traffic accident, machine injuries, assault, gunshot injuries and fall from height. Infections, chronic osteomyelitis, nonunion, loss of function or even limb loss are some serious outcome of deep fracture site infections. The primary goal in management of compound fracture is prevention of infection of bones & soft tissue by early debridement, irrigation of wound and administration of board spectrum antibiotics with stabilization of fractures. Aim: The aim of the study is to observe the pattern of microbial isolates in compound fractures so as to form rationale antibiotic regimen for treating compound fractures. Methods: 40 patients were taken into study of all ages, both the sexes with compound fracture classified according to Gustilo Anderson classification. Primarily wound was examined and classified with 1st culture swab taken at that time followed by 2nd culture swab on 1st dressing and 3rd culture swab if infection continues further. Culture and sensitivity reports were collected for studying pattern of bacterial isolate and their sensitivity. Result: Pre-debridement cultures are of no importance. Postdebridement cultures are important in formulating an antibiotic regime. Gram negative organisms are the most probable cause of infection. Aminoglycosides are the most sensitive group of drugs in both gram +ve & gram –ve bacteria. Cephalosporins or quinolones should be used in combination with aminoglycosides in all cases of compound fracture in our vicinity. Conclusion: All institutions and hospitals should find out the most common infecting pathogen in their environment and formulate an antibiotic policy accordingly.